Provider Demographics
NPI:1477671279
Name:SEILO INC. DBA CHATEAU CARE
Entity Type:Organization
Organization Name:SEILO INC. DBA CHATEAU CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:KOHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-783-5612
Mailing Address - Street 1:975 CO RD 427
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63769
Mailing Address - Country:US
Mailing Address - Phone:573-883-5303
Mailing Address - Fax:573-883-2008
Practice Address - Street 1:820 PARK DR
Practice Address - Street 2:
Practice Address - City:STE GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670
Practice Address - Country:US
Practice Address - Phone:573-883-5303
Practice Address - Fax:573-883-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO035212310400000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO268716107Medicaid