Cathedral Rock of Rolla Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

032162 Issued in MO

Legal business name

CATHEDRAL ROCK OF ROLLA INC

Doing business as

Heritage Park Skilled Care

Practice address

1200 McCutchen Rd
Rolla, MO 65401-2615

Phone

(573) 364-2311

Fax

(573) 364-2748

NPI assigned

Jan 22, 2007

Last updated

Sep 2, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles Kent Harrington

Title

President

Phone

(817) 335-4111

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Park Skilled Care Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220313600000",
    "number": "1598819112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W 7TH ST STE 415",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024905",
            "telephone_number": "817-335-4111",
            "fax_number": "817-335-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MCCUTCHEN RD",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012615",
            "telephone_number": "573-364-2311",
            "fax_number": "573-364-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHEDRAL ROCK OF ROLLA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2008-09-02",
        "status": "A",
        "authorized_official_last_name": "HARRINGTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-335-4111"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "032162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101475408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Park Skilled Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Louise Canell
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• Andrew James Cassidy, DDS
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• Candace Kay Chafton, CNP
• Amy M. Chambers, LPC
• Children's Outreach and Parent Education

• Skilled Nursing Facility in Rolla, MO
• Providers in Rolla, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.