Provider Demographics
NPI:1790290088
Name:GENERAL BAPTIST NURSING HOME OF LINN
Entity Type:Organization
Organization Name:GENERAL BAPTIST NURSING HOME OF LINN
Other - Org Name:LINN OAK REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-598-1020
Mailing Address - Street 1:1287 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PIGGOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72454-1010
Mailing Address - Country:US
Mailing Address - Phone:870-598-1020
Mailing Address - Fax:870-598-1025
Practice Address - Street 1:196 HIGHWAY CC
Practice Address - Street 2:
Practice Address - City:LINN
Practice Address - State:MO
Practice Address - Zip Code:65051-3500
Practice Address - Country:US
Practice Address - Phone:573-897-0700
Practice Address - Fax:573-897-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO045819314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility