Provider Demographics
NPI:1679569057
Name:N & R OF PLATTSBURG, LLC
Entity Type:Organization
Organization Name:N & R OF PLATTSBURG, LLC
Other - Org Name:CLINTON CARE & REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
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 1:253 E HIGHWAY 116
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64477-1561
Mailing Address - Country:US
Mailing Address - Phone:816-539-2376
Mailing Address - Fax:816-539-3187
Practice Address - Street 1:253 E HIGHWAY 116
Practice Address - Street 2:
Practice Address - City:PLATTSBURG
Practice Address - State:MO
Practice Address - Zip Code:64477-1561
Practice Address - Country:US
Practice Address - Phone:816-539-2376
Practice Address - Fax:816-539-3187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO031462314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO18054978OtherSTATE ID
MO109791707Medicaid
MO18054978OtherSTATE ID