Provider Demographics
NPI:1619391521
Name:GENERATIONS HEALTH SYSTEMS OF KELSO, LLC
Entity Type:Organization
Organization Name:GENERATIONS HEALTH SYSTEMS OF KELSO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. ADMINISTRATIVE ASSIST.
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-536-5365
Mailing Address - Street 1:17826 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1262
Mailing Address - Country:US
Mailing Address - Phone:636-536-5365
Mailing Address - Fax:636-536-4533
Practice Address - Street 1:28601 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:SCOTT CITY
Practice Address - State:MO
Practice Address - Zip Code:63780-9143
Practice Address - Country:US
Practice Address - Phone:573-264-1555
Practice Address - Fax:573-264-1556
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEGACY HEALTH SYSTEMS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility