| Organization Name: | SUPERIOR PARK RCF, LLC |
| NPI Number: | 1275891079 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID KAYATTA (OWNER) |
| Mailing Address: | 410 Superior St Excelsior Springs |
| State: | MO US |
| Postal Code: | 640242456 |
| Phone Number: | 8166303177 |
| Fax Number: | |
| NPI Enumeration Date: | 04/30/2012 |
| NPI Last Update Date: | 04/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3104A0625X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | Assisted Living, Mental Illness |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |