Healthcare Provider Details

I. General information

NPI: 1164357265
Provider Name (Legal Business Name): THE BAPTIST HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 SHELBY PLAZA RD
SHELBINA MO
63468-1065
US

IV. Provider business mailing address

400 E HIGH ST STE 600
JEFFERSON CITY MO
65101-3215
US

V. Phone/Fax

Practice location:
  • Phone: 573-588-4175
  • Fax: 573-588-2020
Mailing address:
  • Phone: 573-556-0338
  • Fax:

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: TROY DEAN CULBERTSON
Title or Position: CFO
Credential:
Phone: 573-546-0338