| Midwest Division-lsh.llc | |
| 
					807 W 2nd St Holden MO 64040-1291  | |
| (816) 850-3612 | |
| (816) 850-3982 | 
| Full Name | Midwest Division-lsh.llc | 
|---|---|
| Speciality | Clinic/center - Rural Health | 
| Location | 807 W 2nd St, Holden, Missouri | 
| Authorized Official Name and Position | Matthew Leary (CHIEF FINANCIAL OFFICER) | 
| Authorized Official Contact | 8169696533 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Midwest Division-lsh.llc 807 W 2nd St Holden MO 64040-1291 Ph: (816) 850-3612  | Midwest Division-lsh.llc 807 W 2nd St Holden MO 64040-1291 Ph: (816) 850-3612  | 
| NPI Number | 1427190354 | 
|---|---|
| Provider Enumeration Date | 02/14/2007 | 
| Last Update Date | 08/19/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1427190354 | NPI | - | NPPES | 
| 503228207 | Medicaid | MO | |
| 593228208 | Medicaid | MO | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary | 
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |