Organization
IGNITE MEDICAL RESORT ST. MARYS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY FIELDS (CEO)
(833) 944-6483
Entity
Organization
Contact information
Practice address
111 NW MOCK AVE, BLUE SPRINGS, MO 64014-2503
(816) 220-4200
Mailing address
1550 N NORTHWEST HWY STE 430, PARK RIDGE, IL 60068-1411
(833) 944-6483
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/27/2020
Last updated
01/29/2021
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