Healthcare Provider Details

I. General information

NPI: 1417735648
Provider Name (Legal Business Name): THE BAPTIST HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/02/2025
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N GALLOWAY RD
VANDALIA MO
63382-1252
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 573-594-6467
  • Fax:
Mailing address:
  • Phone: 417-237-9113
  • 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: RODNEY HARRISON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 573-636-0400