1659364206 NPI number — LITTLE HILLS HEALTHCARE, LLC

Table of content: (NPI 1659364206)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659364206 NPI number — LITTLE HILLS HEALTHCARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITTLE HILLS HEALTHCARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CENTERPOINTE HOSPITAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659364206
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4801 WELDON SPRING PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WELDON SPRING
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63304-9101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-441-7300
Provider Business Mailing Address Fax Number:
636-447-6001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4801 WELDON SPRING PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT CHARLES
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63304-5611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-441-7300
Provider Business Practice Location Address Fax Number:
636-447-6001
Provider Enumeration Date:
08/30/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FARLEY
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
VICE PRESIDENT AND SECRETARY
Authorized Official Telephone Number:
615-861-6000

Provider Taxonomy Codes

  • Taxonomy code: 283Q00000X , with the licence number:  475-2 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 011918802 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".