<Unavail>

LBN: Independence Manor Inc
<Unavail> is an health care organization with primary practice located at 1600 S Kings Highway , Independence MO 64055. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Independence Manor Inc can be contacted via phone (816) 833-4777, or through Juckette, Hal via phone (660) 646-5385.

Contact Information

Primary practice address
1600 S Kings Highway Independence MO 64055
Phone: (816) 833-4777
Fax: (816) 833-3032
Website:
Map and Directions
Authorized official contact:
Name: Juckette, Hal
Phone: (660) 646-5385

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 002374 Missouri

Profile Details

NPI number 1255436556
LBN Legal business name Independence Manor Inc
DBA Doing business as <Unavail>
Authorized official Juckette, Hal
Entity Organization
Organization subpart 1 No
Enumeration date Sep 13th, 2006
Last updated Jul 5th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255436556 NPPES
Missouri MEDICAID 107808503

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