Provider Demographics
NPI:1366491656
Name:SYLVIA G. THOMPSON RESIDENCE CENTER
Entity Type:Organization
Organization Name:SYLVIA G. THOMPSON RESIDENCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:OSBURN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:660-826-2118
Mailing Address - Street 1:3333 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-2113
Mailing Address - Country:US
Mailing Address - Phone:660-826-2118
Mailing Address - Fax:660-827-5704
Practice Address - Street 1:3333 W 10TH ST
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2113
Practice Address - Country:US
Practice Address - Phone:660-826-2118
Practice Address - Fax:660-827-5704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO030110314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO410222-1-159-8051OtherUI NUMBER
MO14893355OtherSTATE NUMBER
MO410222-1-159-8051OtherUI NUMBER