Provider Demographics
NPI:1154474005
Name:CAPETOWN ALF BY AMERICARE
Entity Type:Organization
Organization Name:CAPETOWN ALF BY AMERICARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:KRISTEN
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:573-334-4855
Mailing Address - Street 1:2857 CAPE LACROIX RD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-8588
Mailing Address - Country:US
Mailing Address - Phone:573-334-4855
Mailing Address - Fax:573-334-4897
Practice Address - Street 1:2857 CAPE LACROIX RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-8588
Practice Address - Country:US
Practice Address - Phone:573-334-4855
Practice Address - Fax:573-334-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO033613310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility