Provider Demographics
NPI:1528255791
Name:CARNEGIE VILLAGE ASSISTED LIVING
Entity type:Organization
Organization Name:CARNEGIE VILLAGE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:STILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-322-8444
Mailing Address - Street 1:103 BERNARD DR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-6182
Mailing Address - Country:US
Mailing Address - Phone:816-322-8444
Mailing Address - Fax:816-322-8555
Practice Address - Street 1:103 BERNARD DR
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-6182
Practice Address - Country:US
Practice Address - Phone:816-322-8444
Practice Address - Fax:816-322-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO034622310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility