MEDICARE: THE ROSE PALMS CORP.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency		KS

General Provider Information

NPI Number	:	1417160565
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ROSE PALMS CORP.

Provider Business Mailing Address
First Line	:	4039 N 110TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-4489
Country	:	US
Telephone Number	:	913-244-4583
Fax Number	:

Provider Business Practice Location Address
First Line	:	7540 LEAVENWORTH RD STE 7
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-1239
Country	:	US
Telephone Number	:	913-244-4583
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL BROOKS
Credential	:	M.S.
Telephone Number	:	913-244-4583

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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Directions to “THE ROSE PALMS CORP. ” Practice Location

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