Provider Demographics
NPI:1134284094
Name:ROCKHILL MANOR INC
Entity Type:Organization
Organization Name:ROCKHILL MANOR INC
Other - Org Name:ROCKHILL MANOR ASSISTED LIVING
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAHAGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:816-931-2225
Mailing Address - Street 1:PO BOX 5930
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64171-0930
Mailing Address - Country:US
Mailing Address - Phone:816-931-2225
Mailing Address - Fax:
Practice Address - Street 1:4235 LOCUST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-1016
Practice Address - Country:US
Practice Address - Phone:816-931-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO033484320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness