Organization · Type 2 NPI

SRZ Op Autumn LLC

Skilled Nursing Facility · Raytown, MO

NPI number 1366932014 Active

Practice location

6124 Raytown Rd
Raytown, MO 64133

Call (816) 358-8222 Map

Mailing address

22 Herrick Dr
Lawrence, NY 11559-1528

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

8 other providers at this address

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NPI record

NPI: 1366932014
Entity type: Organization (Type 2)
Issued: May 17, 2018
Last updated: Sep 16, 2022
Status: Active
Subpart: Yes of SRZ Op Holdings LLC

Other names

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Polaris Health & Wellness of Autumn Terrace · doing business as

Authorized official

Samuel Goldner
Authorized Person/official
(347) 677-0448

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1366932014

SRZ Op Autumn LLC's National Provider Identifier is 1366932014, issued on May 17, 2018. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Raytown, MO. The record was last updated on Sep 16, 2022.