Provider Demographics
NPI:1013338268
Name:PROMISE SKILLED NURSING FACILITY OF OVERLAND PARK, INC.
Entity Type:Organization
Organization Name:PROMISE SKILLED NURSING FACILITY OF OVERLAND PARK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-869-3100
Mailing Address - Street 1:999 YAMATO RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4477
Mailing Address - Country:US
Mailing Address - Phone:561-869-3100
Mailing Address - Fax:561-826-0171
Practice Address - Street 1:6505 W 103RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1728
Practice Address - Country:US
Practice Address - Phone:913-649-3701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMISE HEALTHCARE #2, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-13
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility