Healthcare Provider Details
I. General information
NPI: 1942232947
Provider Name (Legal Business Name): HUNTER ACRES CARING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2006
Last Update Date: 08/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
628 N WEST ST
SIKESTON MO
63801-4738
US
IV. Provider business mailing address
PO BOX 1210
SIKESTON MO
63801-1210
US
V. Phone/Fax
- Phone: 573-471-7130
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 045271 |
| License Number State | MO |
VIII. Authorized Official
Name:
DONALD
B
BEDELL
Title or Position: PRESIDENT
Credential:
Phone: 573-471-1276