Provider Demographics
NPI:1497741698
Name:N & R OF SILEX, INC.
Entity Type:Organization
Organization Name:N & R OF SILEX, INC.
Other - Org Name:SILEX COMMUNITY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:LINCOLN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-746-7100
Mailing Address - Street 1:111 DUNCAN MANSION DR
Mailing Address - Street 2:
Mailing Address - City:SILEX
Mailing Address - State:MO
Mailing Address - Zip Code:63377-2229
Mailing Address - Country:US
Mailing Address - Phone:573-384-5218
Mailing Address - Fax:573-384-5470
Practice Address - Street 1:111 DUNCAN MANSION DR
Practice Address - Street 2:
Practice Address - City:SILEX
Practice Address - State:MO
Practice Address - Zip Code:63377-2229
Practice Address - Country:US
Practice Address - Phone:573-384-5218
Practice Address - Fax:573-384-5470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO029744314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO103548103Medicaid
MO16780906OtherSTATE ID
MO16780906OtherSTATE ID