Stroetker Diversivied Inc

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

035264 Issued in MO

Legal business name

STROETKER DIVERSIVIED INC

Doing business as

maywood manor

Practice address

1041 W Truman Rd
Independence, MO 64050-3447

Phone

(816) 254-6789

NPI assigned

Jun 24, 2008

Last updated

Jun 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Herman Stroetker

Title

President

Phone

(816) 254-6789

Specialties & licenses 1

Addresses

Other names 1

• maywood manor Doing business as

Tax ID family

Maywood Manor2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Maywood Manor

  • Assisted Living Facility (Mental Illness)
  • Independence, MO
  • NPI 1831302827
  NPD tax ID

Locations

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1790946549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 W TRUMAN RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640503447",
            "telephone_number": "816-254-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 W TRUMAN RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640503447",
            "telephone_number": "816-254-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STROETKER DIVERSIVIED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "STROETKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HERMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-254-6789"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MO",
            "license": "035264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "maywood manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Breanna Strange, PHARMD
• Stephanie M Straub, DDS
• William Patrick Streck, PT, DPT, MAM, CSCS
• Jabrea Strickland, OD
• Cynthia Stringer
• Patricia Strutz, MD
• Holly Christina Stubbs, CRNA
• William G Stueve, MD
• Robert A Sturges, O.D.
• Marie S. Styles

• Assisted Living Facility (Mental Illness) in Independence, MO
• Providers in Independence, 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 Jun 24, 2008; 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.