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General NPI Number Information
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NPI Number | 1518857713
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Entity Type | Organization
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Legal Business Name | ANNIES GARDEN SKILLED NURSING LLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 302 STALLCUP DR
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City | SIKESTON
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State | MO
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Zip | 63801-9387
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Country | US
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Telephone | 573-621-4910
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Fax | 573-258-9823
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Provider Business Mailing Address
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Address Line | 302 STALLCUP DR
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City | SIKESTON
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State | MO
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Zip | 63801-9387
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Country | US
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Telephone | 573-621-4910
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Fax | 573-258-9823
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Authorized Official
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Title or Position | CEO
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Name | MR. BENJAMIN P SELLS
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Credential |
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Telephone | 573-614-7472
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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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