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General NPI Number Information
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NPI Number | 1821179789
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Entity Type | Organization
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Legal Business Name | COUNTRY MEADOWS NURSING & REHAB LLC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1301 NORTH SAINT JOE DRIVE
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City | PARK HILLS
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State | MO
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Zip | 63601-1965
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Country | US
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Telephone | 573-431-2889
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Fax | 573-431-2822
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Provider Business Mailing Address
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Address Line | 1301 NORTH SAINT JOE DRIVE
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City | PARK HILLS
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State | MO
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Zip | 63601-1965
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Country | US
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Telephone | 573-431-2889
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Fax | 573-431-2822
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 032558
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 032557
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License Number State | MO
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