Healthcare Provider Details

I. General information

NPI: 1881545150
Provider Name (Legal Business Name): N & R OF BETHANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 S 7TH ST
BETHANY MO
64424-1780
US

IV. Provider business mailing address

1305 S 7TH ST
BETHANY MO
64424-1780
US

V. Phone/Fax

Practice location:
  • Phone: 573-481-9625
  • Fax:
Mailing address:
  • Phone: 573-481-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CARLA HEDRICK
Title or Position: CFO
Credential: CFO
Phone: 573-481-9625