Edgewood Manor
LBN: Deaconess Long Term Care Of Missouri, Inc
Edgewood Manor is an health care organization with primary practice located at 11900 Jessica Ln , Raytown MO 64138-2649. 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.
Deaconess Long Term Care Of Missouri, Inc can be contacted via phone (816) 358-7858, or through Brooks, Carla via phone (513) 487-3600.
Contact Information
Primary practice address
11900 Jessica Ln
Raytown MO 64138-2649
Phone: (816) 358-7858
Fax: (816) 353-1514
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 029538 | Missouri |
Profile Details
| NPI number | 1164416509 |
|---|---|
| LBN Legal business name | Deaconess Long Term Care Of Missouri, Inc |
| DBA Doing business as | Edgewood Manor |
| Authorized official | Brooks, Carla |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Oct 7th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164416509 | NPPES |
| Missouri | Other | 90399-010 | BLUE SHIELD |
| Missouri | Other | 262783806 | BLUE SHIELD |
| Missouri | Other | 5397477 | BLUE SHIELD |
| Missouri | Other | 90399-010 | BLUE SHIELD |
| Missouri | MEDICAID | 102783800 | BLUE SHIELD |
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