Provider Demographics
NPI:1871658799
Name:HEALTH CARE CONSULTANTS OF MID MISSOURI, INC.
Entity Type:Organization
Organization Name:HEALTH CARE CONSULTANTS OF MID MISSOURI, INC.
Other - Org Name:MAPLELAWN RESIDENTIAL CARE FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUDROFF
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:573-489-0246
Mailing Address - Street 1:420 CTY. RD. 112
Mailing Address - Street 2:PO BOX 271
Mailing Address - City:FAYETTE
Mailing Address - State:MO
Mailing Address - Zip Code:65248
Mailing Address - Country:US
Mailing Address - Phone:660-248-3626
Mailing Address - Fax:660-248-2166
Practice Address - Street 1:420 COUNTY ROAD 112
Practice Address - Street 2:
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248
Practice Address - Country:US
Practice Address - Phone:660-248-3626
Practice Address - Fax:660-248-2166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2516-90323104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness