Healthcare Provider Details

I. General information

NPI: 1154328953
Provider Name (Legal Business Name): HEALTH SERVICES ADMINISTRATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E HIGHWAY 22
CENTRALIA MO
65240-1146
US

IV. Provider business mailing address

750 E HIGHWAY 22
CENTRALIA MO
65240-1146
US

V. Phone/Fax

Practice location:
  • Phone: 573-682-5551
  • Fax: 573-682-1469
Mailing address:
  • Phone: 573-682-5551
  • Fax: 573-682-1469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number031309
License Number StateMO

VIII. Authorized Official

Name: MR. JAMES REIKER
Title or Position: VICE PRESIDENT - FINANCE
Credential:
Phone: 573-471-1113