# FIVE STAR OVERLAND PARK LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FIVE STAR OVERLAND PARK LLC
- **Other names:** The Forum at Overland Park
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154376515
- **Legal business name:** FIVE STAR OVERLAND PARK LLC
- **Authorized official:** KATHERINE E POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (617) 796-8387

## Contact information

- **Practice address:** 3501 WEST 95TH ST, OVERLAND PARK, KS 66206-2063
- **Practice address phone:** (913) 648-4500
- **Practice address fax:** (913) 648-6144
- **Mailing address:** 400 CENTRE ST, NEWTON, MA 02458
- **Mailing address phone:** (617) 796-8387
- **Mailing address fax:** (617) 796-8375

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | N046033 | KS | — |
| 314000000X | Skilled Nursing Facility | N046033 | KS | Yes |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 03/28/2019