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General NPI Number Information
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NPI Number | 1780923318
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Entity Type | Organization
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Legal Business Name | N & R OF ST CHARLES LLC
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 1221 BOONES LICK RD
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2328
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Country | US
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Telephone | 636-946-6140
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Fax | 636-757-1141
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Provider Business Mailing Address
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Address Line | PO BOX 1559
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City | SIKESTON
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State | MO
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Zip | 63801-1559
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Country | US
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Telephone | 573-481-9625
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Fax | 573-481-0773
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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 | CFO
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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 | 101482206
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License Number State | MO
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