Organization
HIDDEN LAKE MANAGEMENT LLC
Active
Other names
Hidden Lake Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUDAH BIENSTOCK (MANAGING MEMBER)
(314) 812-2550
Entity
Organization
Contact information
Practice address
11400 HIDDEN LAKE DR, RAYTOWN, MO 64133-7409
(816) 737-1010
(816) 737-3022
Mailing address
11400 HIDDEN LAKE DR, RAYTOWN, MO 64133-7409
(816) 737-1010
(816) 737-3022
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
MO
Other
Enumeration date
07/17/2012
Last updated
12/02/2015
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