Healthcare Provider Details

I. General information

NPI: 1881839728
Provider Name (Legal Business Name): WESTFIELD NURSING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3144 STATE HIGHWAY FF
SIKESTON MO
63801-8580
US

IV. Provider business mailing address

3144 STATE HIGHWAY FF
SIKESTON MO
63801-8580
US

V. Phone/Fax

Practice location:
  • Phone: 573-471-1174
  • Fax: 573-471-1944
Mailing address:
  • Phone: 573-471-1174
  • Fax: 573-471-1944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number044781
License Number StateMO

VIII. Authorized Official

Name: MR. BENJAMIN PACK SELLS
Title or Position: PRESIDENT
Credential:
Phone: 573-471-1174