Healthcare Provider Details

I. General information

NPI: 1336235936
Provider Name (Legal Business Name): N & R OF FARMINGTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 OLD JACKSON RD
FARMINGTON MO
63640
US

IV. Provider business mailing address

1180 OLD JACKSON RD
FARMINGTON MO
63640-3428
US

V. Phone/Fax

Practice location:
  • Phone: 573-760-1700
  • Fax: 573-760-1224
Mailing address:
  • Phone: 573-760-1700
  • Fax: 573-760-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number036144
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number042117
License Number StateMO

VIII. Authorized Official

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