Healthcare Provider Details

I. General information

NPI: 1649971367
Provider Name (Legal Business Name): PATAKY CARE PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 E CANAAN RD
GERALD MO
63037-2515
US

IV. Provider business mailing address

533 E CANAAN RD
GERALD MO
63037-2515
US

V. Phone/Fax

Practice location:
  • Phone: 573-764-5141
  • Fax:
Mailing address:
  • Phone: 573-764-5141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: MRS. JAMIE L PATAKY
Title or Position: OWNER/ DIRECTOR OF NURSING
Credential: RN
Phone: 636-744-2550