Provider Demographics
NPI:1609311133
Name:KANSAS CITY COMMUNITY HOSPITAL, LLC
Entity Type:Organization
Organization Name:KANSAS CITY COMMUNITY HOSPITAL, LLC
Other - Org Name:SAINT LUKE'S COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CBO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSQUERA-PALACIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-999-0832
Mailing Address - Street 1:1415 LOUISIANA ST
Mailing Address - Street 2:27TH FLOOR
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-7360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13200 STATE LINE ROAD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:844-285-1005
Practice Address - Fax:855-490-1799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital