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General NPI Number Information
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NPI Number | 1649242876
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Entity Type | Organization
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Legal Business Name | GRUNDY COUNTY NURSING HOME DISTRICT
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1311 E 28TH ST
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City | TRENTON
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State | MO
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Zip | 64683
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Country | US
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Telephone | 660-359-5647
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Fax | 660-359-4111
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Provider Business Mailing Address
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Address Line | 1311 E 28TH ST
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City | TRENTON
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State | MO
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Zip | 64683
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Country | US
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Telephone | 660-359-5647
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Fax | 660-359-4111
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. PATRISHA SMITH
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Credential | LNHA
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Telephone | 660-359-5647
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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 | 035512
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License Number State |
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