- Enrollment id
- O20150216000508
- Enrollment state
- KS
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1376940270
- Multiple npi flag
- N
- Ccn
- 175158
- Associate id
- 5698090678
- Organization name
- OVERLAND PARK MEDICAL INVESTORS LLC
- Doing business as name
- GARDEN TERRACE AT OVERLAND PARK
- Organization type structure
- LLC
- Proprietary nonprofit
- D
- Nursing home provider name
- GARDEN TERRACE AT OVERLAND PARK
- Affiliation entity name
- LIFE CARE CENTERS OF AMERICA
- Affiliation entity id
- 311
- Address line 1
- 7541 SWITZER ST
- City
- OVERLAND PARK
- State
- KS
- Zip code
- 662141170