Provider Demographics
NPI:1346392081
Name:BRAUN ENTERPRISES, INC
Entity Type:Organization
Organization Name:BRAUN ENTERPRISES, INC
Other - Org Name:SOUTHSIDE TOWNE HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDROFF
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:573-489-0246
Mailing Address - Street 1:510 S WASHINGTON ST
Mailing Address - Street 2:PO BOX 6
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-2657
Mailing Address - Country:US
Mailing Address - Phone:573-581-3203
Mailing Address - Fax:573-581-6544
Practice Address - Street 1:510 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-2657
Practice Address - Country:US
Practice Address - Phone:573-581-3203
Practice Address - Fax:573-581-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness