Healthcare Provider Details

I. General information

NPI: 1407832876
Provider Name (Legal Business Name): ROSE HILL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N ROSE HILL RD
ROSE HILL KS
67133-9336
US

IV. Provider business mailing address

601 N ROSE HILL RD
ROSE HILL KS
67133-9336
US

V. Phone/Fax

Practice location:
  • Phone: 316-776-2194
  • Fax: 316-776-9370
Mailing address:
  • Phone: 316-776-2194
  • Fax: 316-776-9370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberN008004
License Number StateKS

VIII. Authorized Official

Name: MR. LARRY DEAN WILKERSON
Title or Position: MEMBER ADMINISTRATOR
Credential:
Phone: 316-776-2194