Organization
SA-ENC GLENNON PLACE, LLC
Active
Other names
Glennon Place Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL STARER (AUTHORIZED REPRESENTATIVE)
(914) 390-4300
Entity
Organization
Contact information
Practice address
128 N HARDESTY AVE, KANSAS CITY, MO 64123-1404
(816) 241-2020
Mailing address
4 W RED OAK LN, SUITE 201, WHITE PLAINS, NY 10604-3603
(914) 390-4300
(914) 251-8191
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
33399
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33399
—
MO
Enumeration date
03/01/2007
Last updated
10/30/2013
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