Provider Demographics
NPI:1932775673
Name:THE BAPTIST HOME
Entity type:Organization
Organization Name:THE BAPTIST HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, MA, RN
Authorized Official - Phone:573-418-1310
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65102-0397
Mailing Address - Country:US
Mailing Address - Phone:573-573-6360
Mailing Address - Fax:573-686-2267
Practice Address - Street 1:17451 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1805
Practice Address - Country:US
Practice Address - Phone:816-373-7795
Practice Address - Fax:816-373-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2023-10-17
Deactivation Date:2023-09-19
Deactivation Code:
Reactivation Date:2023-10-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility