Organization
KAW RIVER OPERATOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART LINDEMAN (PRESIDENT AND CEO)
(813) 280-1333
Entity
Organization
Contact information
Practice address
750 BLAKE ST, EDWARDSVILLE, KS 66111-1339
(913) 422-5832
Mailing address
2907 W BAY TO BAY BLVD STE 303, TAMPA, FL 33629-8187
(813) 280-1333
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N105003
KANSAS STATE LICENSE NUMBER
KS
Enumeration date
09/11/2019
Last updated
09/11/2019
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