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General NPI Number Information
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NPI Number | 1154317535
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Entity Type | Organization
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Legal Business Name | N & R OF SIKESTON AT CLEARVIEW INC
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 430 W SALCEDO RD
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City | SIKESTON
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State | MO
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Zip | 63801-4802
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Country | US
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Telephone | 573-471-2565
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Fax | 573-471-6155
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Provider Business Mailing Address
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Address Line | 430 W SALCEDO RD
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City | SIKESTON
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State | MO
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Zip | 63801-4802
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Country | US
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Telephone | 573-471-2565
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Fax | 573-471-6155
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Authorized Official
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Title or Position | CFO
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Name | CARLA HEDRICK
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Credential |
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Telephone | 573-481-9625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 029830
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License Number State | MO
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