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Organization

SUPERIOR PARK RCF, LLC

Active
Other names
Superior Park
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID KAYATTA (OWNER)
(909) 581-7120
Entity
Organization

Contact information

Practice address
410 SUPERIOR ST, EXCELSIOR SPRINGS, MO 64024-2456
(816) 630-3177
Mailing address
410 SUPERIOR ST, EXCELSIOR SPRINGS, MO 64024-2456
(816) 630-3177

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
MO

Other

Enumeration date
04/30/2012
Last updated
04/30/2012
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