Provider Demographics
NPI:1871578633
Name:HILLTOP MANOR, INC.
Entity type:Organization
Organization Name:HILLTOP MANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHLENE 'KATHY'
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-298-2781
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:403 S. VALLEY
Mailing Address - City:CUNNINGHAM
Mailing Address - State:KS
Mailing Address - Zip Code:67035-0008
Mailing Address - Country:US
Mailing Address - Phone:620-298-2781
Mailing Address - Fax:620-298-3437
Practice Address - Street 1:403 S. VALLEY
Practice Address - Street 2:
Practice Address - City:CUNNINGHAM
Practice Address - State:KS
Practice Address - Zip Code:67035-0008
Practice Address - Country:US
Practice Address - Phone:620-298-2781
Practice Address - Fax:620-298-3437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN-048-001313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSN-048-001OtherSTATE LICENSE ID NUMBER