Harrisonville Long Term Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HARRISONVILLE LONG TERM CARE LLC

Practice address

307 E South St
Harrisonville, MO 64701-3241

Phone

(816) 380-7399

Fax

(816) 380-6352

NPI assigned

Sep 5, 2013

Organization subpart

No

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

Authorized official

Name

Kam McGavock

Title

President

Phone

(410) 773-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ABC Health Care Doing business as

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1932534278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E SOUTH ST",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647013241",
            "telephone_number": "816-380-7399",
            "fax_number": "816-380-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISONVILLE LONG TERM CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "MCGAVOCK",
        "authorized_official_first_name": "KAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-773-1000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101472900",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Harrisonville, MO
• Providers in Harrisonville, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.