Healthcare Provider Details

I. General information

NPI: 1588610521
Provider Name (Legal Business Name): N & R OF REPUBLIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S COTTONWOOD AVE
REPUBLIC MO
65738-2093
US

IV. Provider business mailing address

300 S COTTONWOOD AVE
REPUBLIC MO
65738-2093
US

V. Phone/Fax

Practice location:
  • Phone: 417-732-2929
  • Fax: 417-732-9913
Mailing address:
  • Phone: 417-233-7032
  • Fax: 417-233-7033

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
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number037410
License Number StateMO

VIII. Authorized Official

Name: CARLA HEDRICK
Title or Position: CFO
Credential: CFO
Phone: 573-481-9325