Provider Demographics
NPI:1710039789
Name:STRATFORD SPECIALTY CARE INC
Entity Type:Organization
Organization Name:STRATFORD SPECIALTY CARE INC
Other - Org Name:SEASONS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MARONEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:816-478-4757
Mailing Address - Street 1:15600 WOODS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64139-1354
Mailing Address - Country:US
Mailing Address - Phone:816-478-4757
Mailing Address - Fax:816-478-8338
Practice Address - Street 1:15600 WOODS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64139-1354
Practice Address - Country:US
Practice Address - Phone:816-478-4757
Practice Address - Fax:816-478-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO585261QA0600X
MO033210314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO105815500Medicaid