Provider Demographics
NPI:1033105226
Name:N & R OF SENATH NORTH, INC.
Entity Type:Organization
Organization Name:N & R OF SENATH NORTH, INC.
Other - Org Name:SENATH NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSPETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-392-0316
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:573-738-2670
Practice Address - Street 1:HIGHWAY 412 S
Practice Address - Street 2:
Practice Address - City:SENATH
Practice Address - State:MO
Practice Address - Zip Code:63876
Practice Address - Country:US
Practice Address - Phone:573-738-2627
Practice Address - Fax:573-738-2670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO031497314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101495406Medicaid
MO16878167OtherSTATE ID
MO101495406Medicaid