1457898652 NPI number — TALLGRASS CREEK, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457898652 NPI number — TALLGRASS CREEK, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TALLGRASS CREEK, INC.
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:
Provider Other Organization Name Type Code:
6
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:
1457898652
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13800 METCALF AVE
Provider Second Line Business Mailing Address:
ATTN: EXECUTIVE DIRECTOR
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66223-1200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-897-2700
Provider Business Mailing Address Fax Number:
410-204-7237

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13800 METCALF AVE
Provider Second Line Business Practice Location Address:
ATTN: REHABILITATION MANAGER
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66223-1200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-897-2700
Provider Business Practice Location Address Fax Number:
410-204-7237
Provider Enumeration Date:
01/25/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WALTER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
K
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
410-402-2315

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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