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General NPI Number Information
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NPI Number | 1891872974
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Entity Type | Organization
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Legal Business Name | SPRING RIVER CHRISTIAN VILLAGE, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 201 S NORTHPARK LN
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City | JOPLIN
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State | MO
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Zip | 64801-8426
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Country | US
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Telephone | 417-623-4313
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Fax | 417-623-5478
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Provider Business Mailing Address
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Address Line | 201 S NORTHPARK LN
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City | JOPLIN
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State | MO
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Zip | 64801-8426
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Country | US
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Telephone | 417-623-4313
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Fax | 417-623-5478
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. SUSAN MCGHEE
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Credential |
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Telephone | 314-587-7903
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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 | 032994
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License Number State | MO
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