Healthcare Provider Details

I. General information

NPI: 1386070712
Provider Name (Legal Business Name): SENATH SOUTH NURSING AND REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E HORNBECK ST
SENATH MO
63876-9225
US

IV. Provider business mailing address

PO BOX 940
SENATH MO
63876-0940
US

V. Phone/Fax

Practice location:
  • Phone: 573-738-2627
  • Fax: 573-738-3205
Mailing address:
  • Phone: 573-738-2627
  • Fax: 573-738-3205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL A RICH
Title or Position: PRESIDENT
Credential:
Phone: 940-387-4388