Basic Information
| Provider Information | |||||||||
| NPI: | 1407832876 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROSE HILL HEALTH SERVICES, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LAKEPOINT NURSING AND REHABILITATION CENTER ROSE HILL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 N ROSE HILL RD | ||||||||
| Address2: | |||||||||
| City: | ROSE HILL | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671339336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3167762194 | ||||||||
| FaxNumber: | 3167769370 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 N ROSE HILL RD | ||||||||
| Address2: | |||||||||
| City: | ROSE HILL | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671339336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3167762194 | ||||||||
| FaxNumber: | 3167769370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2005 | ||||||||
| LastUpdateDate: | 06/14/2012 | ||||||||
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| AuthorizedOfficialLastName: | WILKERSON | ||||||||
| AuthorizedOfficialFirstName: | LARRY | ||||||||
| AuthorizedOfficialMiddleName: | DEAN | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3167762194 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 311ZA0620X | N008004 | KS | Y | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
ID Information
| ID | Type | State | Issuer | Description | 100111280A | 05 | KS | MEDICAID |