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NPI Code Detail

MEDICARE: LUTHERAN HOME FOR TH E AGED

MEDICARE: LUTHERAN HOME FOR TH E AGED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251G00000XCommunity Based Hospice Care Agency134-2HOMO

General Provider Information

NPI Number : 1851353338
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN HOME FOR TH E AGED
Provider Business Mailing Address
First Line : 2825 BLOOMFIELD RD
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-6335
Country : US
Telephone Number : 573-334-1515
Fax Number :
Provider Business Practice Location Address
First Line : 2825 BLOOMFIELD RD
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-6335
Country : US
Telephone Number : 573-334-1515
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MRS. MELINDA GRACE III
Credential : RN
Telephone Number : 573-334-1515
Provider Enumeration Date : 04/03/2006
Last Update Date : 08/22/2020

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Directions to “LUTHERAN HOME FOR TH E AGED ” Practice Location

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