Superior Park RCF, LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

SUPERIOR PARK RCF, LLC

Doing business as

Superior Park

Practice address

410 Superior St
Excelsior Springs, MO 64024-2456

Phone

(816) 630-3177

NPI assigned

Apr 30, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Kayatta

Title

Owner

Phone

(909) 581-7120

Specialties & licenses 1

Addresses

Other names 1

• Superior Park Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1275891079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 SUPERIOR ST",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640242456",
            "telephone_number": "816-630-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 SUPERIOR ST",
            "city": "EXCELSIOR SPRINGS",
            "state": "MO",
            "postal_code": "640242456",
            "telephone_number": "816-630-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR PARK RCF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "KAYATTA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-581-7120"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility (Mental Illness) in Excelsior Springs, MO
• Providers in Excelsior Springs, MO by specialty
• Assisted Living Facility (Mental Illness) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.