Organization
LONG TERM CARE ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL H NIELSON MD (OWNER)
(816) 803-5173
Entity
Organization
Contact information
Practice address
3619 S DELAWARE AVE, INDEPENDENCE, MO 64055-3188
(816) 803-5173
(816) 461-2367
Mailing address
PO BOX 752, CONCORDIA, MO 64020-0752
(660) 463-1365
(660) 463-1367
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505740902
—
MO
Enumeration date
08/12/2006
Last updated
07/25/2012
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