| NPI | 1518010131 |
|---|---|
| Doing Business As | EASTGATE MANOR |
| Entity Type | Organization |
| Authorized Contact | BRADLEY STEVEN WICKHAM Vice President 816-279-0587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MO 031734) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |