Healthcare Provider Details

I. General information

NPI: 1346392081
Provider Name (Legal Business Name): BRAUN ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S WASHINGTON ST
MEXICO MO
65265-2657
US

IV. Provider business mailing address

510 S WASHINGTON ST PO BOX 6
MEXICO MO
65265-2657
US

V. Phone/Fax

Practice location:
  • Phone: 573-581-3203
  • Fax: 573-581-6544
Mailing address:
  • Phone: 573-581-3203
  • Fax: 573-581-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SUE RUDROFF
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 573-489-0246