Provider Demographics
NPI:1801184593
Name:SEASONS SPECIALTY CARE INC
Entity Type:Organization
Organization Name:SEASONS SPECIALTY CARE INC
Other - Org Name:SEASONS DAY SERVICES PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
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:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO815311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0007834Medicaid