Provider Demographics
NPI:1386070712
Name:SENATH SOUTH NURSING AND REHABILITATION, LLC
Entity type:Organization
Organization Name:SENATH SOUTH NURSING AND REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-387-4388
Mailing Address - Street 1:PO BOX 940
Mailing Address - Street 2:
Mailing Address - City:SENATH
Mailing Address - State:MO
Mailing Address - Zip Code:63876-0940
Mailing Address - Country:US
Mailing Address - Phone:573-738-2627
Mailing Address - Fax:573-738-3205
Practice Address - Street 1:300 E HORNBECK ST
Practice Address - Street 2:
Practice Address - City:SENATH
Practice Address - State:MO
Practice Address - Zip Code:63876-9225
Practice Address - Country:US
Practice Address - Phone:573-738-2627
Practice Address - Fax:573-738-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
265832Medicare Oscar/Certification