Healthcare Provider Details

I. General information

NPI: 1023220811
Provider Name (Legal Business Name): MISSOURI VETERANS COMMISSION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 VETERANS ROAD
WARRENSBURG MO
64093
US

IV. Provider business mailing address

1300 VETERANS ROAD
WARRENSBURG MO
64093
US

V. Phone/Fax

Practice location:
  • Phone: 660-543-5064
  • Fax: 660-543-5075
Mailing address:
  • Phone: 660-543-5064
  • Fax: 660-543-5075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ERIC JOHN ENDSLEY
Title or Position: ADMINISTRATOR
Credential: MHSA, LNHA
Phone: 660-543-5064