Organization
BLISS MANOR, INC.
Active
Other names
Eastgate Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY STEVEN WICKHAM (VICE-PRESIDENT)
(816) 279-0587
Entity
Organization
Contact information
Practice address
2102 VILLAGE DR, SAINT JOSEPH, MO 64506-4983
(816) 233-2141
(816) 233-2141
Mailing address
PO BOX 7350, SAINT JOSEPH, MO 64507-7350
(816) 279-0587
(816) 279-3461
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
031734
MO
Other
Enumeration date
01/18/2007
Last updated
08/22/2020
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