Provider Demographics
NPI:1033142153
Name:TIFFANY CARE CENTERS, INC
Entity Type:Organization
Organization Name:TIFFANY CARE CENTERS, INC
Other - Org Name:PLEASANT VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RHINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-744-6252
Mailing Address - Street 1:470 RAINBOW DR
Mailing Address - Street 2:P.O BOX 273
Mailing Address - City:ROCK PORT
Mailing Address - State:MO
Mailing Address - Zip Code:64482-1641
Mailing Address - Country:US
Mailing Address - Phone:660-744-6252
Mailing Address - Fax:
Practice Address - Street 1:470 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:ROCK PORT
Practice Address - State:MO
Practice Address - Zip Code:64482-1641
Practice Address - Country:US
Practice Address - Phone:660-744-6252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO032304314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101475705Medicaid
MO265744Medicare Oscar/Certification