Provider Demographics
NPI:1720204928
Name:WHISPERING OAKS HEALTH CARE CENTER, INC
Entity Type:Organization
Organization Name:WHISPERING OAKS HEALTH CARE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PEQUENO
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:636-256-7700
Mailing Address - Street 1:1450 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63021-2000
Mailing Address - Country:US
Mailing Address - Phone:636-256-7700
Mailing Address - Fax:636-256-0559
Practice Address - Street 1:1450 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63021-2000
Practice Address - Country:US
Practice Address - Phone:636-256-7700
Practice Address - Fax:636-256-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0317663104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO55240201898059OtherMISSOURI ID
MO=========OtherFEIN