Provider Demographics
NPI:1558356295
Name:NEW FLORENCE NURSING HOME, INC
Entity Type:Organization
Organization Name:NEW FLORENCE NURSING HOME, INC
Other - Org Name:NEW FLORENCE NURSING AND CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:GAY
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-835-2025
Mailing Address - Street 1:515 PICNIC ST
Mailing Address - Street 2:
Mailing Address - City:NEW FLORENCE
Mailing Address - State:MO
Mailing Address - Zip Code:63363-2223
Mailing Address - Country:US
Mailing Address - Phone:573-835-2025
Mailing Address - Fax:573-835-2026
Practice Address - Street 1:515 PICNIC ST
Practice Address - Street 2:
Practice Address - City:NEW FLORENCE
Practice Address - State:MO
Practice Address - Zip Code:63363-2223
Practice Address - Country:US
Practice Address - Phone:573-835-2025
Practice Address - Fax:573-835-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO31040000X310400000X
MO314000000X314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO10149216Medicaid
MO265625Medicare Oscar/Certification