National Provider Identifier Database

INDEPENDENCE MANOR INC
Skilled Nursing Facility

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.


Contact Information

INDEPENDENCE MANOR INC
1600 S KINGS HIGHWAY
INDEPENDENCE, MO64055
Phone: 816-833-4777
Fax: 816-833-3032
Website:
Specialty Taxonomy Code
* Skilled Nursing Facility 314000000X

* Indicates primary specialty

NPI Profile & details for INDEPENDENCE MANOR INC

NPI Number 1255436556
Legal business name
LBN
INDEPENDENCE MANOR INC
Authorized official HAL JUCKETTE - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/13/2006
Last updated 07/05/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 002374
  • MO Medicaid: 107808503

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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