Provider Demographics
NPI:1043217508
Name:COMMUNITY CARE CENTER OF AURORA, INC
Entity Type:Organization
Organization Name:COMMUNITY CARE CENTER OF AURORA, INC
Other - Org Name:AURORA NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GIARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-394-3000
Mailing Address - Street 1:437 SOVEREIGN CT REAR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4432
Mailing Address - Country:US
Mailing Address - Phone:636-394-3000
Mailing Address - Fax:
Practice Address - Street 1:1700 S HUDSON AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:MO
Practice Address - Zip Code:65605-2717
Practice Address - Country:US
Practice Address - Phone:417-678-2165
Practice Address - Fax:417-678-2164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO033521314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101479509Medicaid
MO265182Medicare Oscar/Certification