Provider Demographics
NPI:1437231180
Name:LIVINGSTON COUNTY NURSING HOME DISTRICT
Entity Type:Organization
Organization Name:LIVINGSTON COUNTY NURSING HOME DISTRICT
Other - Org Name:MORNINGSIDE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SWEETS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHD
Authorized Official - Phone:660-646-0170
Mailing Address - Street 1:1700 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-1545
Mailing Address - Country:US
Mailing Address - Phone:660-646-0170
Mailing Address - Fax:660-646-0173
Practice Address - Street 1:1700 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-1545
Practice Address - Country:US
Practice Address - Phone:660-646-0170
Practice Address - Fax:660-646-0173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO032033310400000X
MO034558314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
265813Medicare Oscar/Certification