Organization
ROLLA HEALTH CARE LLC
Active
Other names
Rolla Health & Rehabilitation Suites
Organization subpart
No
Provider details
NPI number
Authorized official
KAM MCGAVOCK (PRESIDENT)
(410) 773-1000
Entity
Organization
Contact information
Practice address
1200 MCCUTCHEN RD, ROLLA, MO 65401-2615
(573) 364-2311
(573) 364-2748
Mailing address
920 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101475408
—
MO
Enumeration date
09/05/2013
Last updated
05/16/2014
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