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General NPI Number Information
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NPI Number | 1518436724
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Entity Type | Organization
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Legal Business Name | MISSOURI NURSING HOME & REHAB LLC
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Dates
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Enumeration Date | 11/16/2018
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 783 WEBER ROAD
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City | FARMINGTON
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State | MO
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Zip | 63640-3318
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Country | US
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Telephone | 573-756-8998
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Fax | 573-756-1577
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Provider Business Mailing Address
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Address Line | 2215 BROADWAY ST
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-4403
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Country | US
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Telephone | 573-271-5311
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Fax | 573-335-6724
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SHAFIQ M MALIK
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Credential |
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Telephone | 573-335-3044
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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 |
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License Number State |
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