Basic Information
| Provider Information | |||||||||
| NPI: | 1386070712 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SENATH SOUTH NURSING AND REHABILITATION, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 940 | ||||||||
| Address2: | |||||||||
| City: | SENATH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 638760940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737382627 | ||||||||
| FaxNumber: | 5737383205 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 E HORNBECK ST | ||||||||
| Address2: | |||||||||
| City: | SENATH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 638769225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737382627 | ||||||||
| FaxNumber: | 5737383205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2013 | ||||||||
| LastUpdateDate: | 02/07/2014 | ||||||||
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| AuthorizedOfficialLastName: | RICH | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9403874388 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.