Provider Demographics
NPI:1881839728
Name:WESTFIELD NURSING CENTER, INC.
Entity Type:Organization
Organization Name:WESTFIELD NURSING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:PACK
Authorized Official - Last Name:SELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-471-1174
Mailing Address - Street 1:3144 STATE HIGHWAY FF
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-8580
Mailing Address - Country:US
Mailing Address - Phone:573-471-1174
Mailing Address - Fax:573-471-1944
Practice Address - Street 1:3144 STATE HIGHWAY FF
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-8580
Practice Address - Country:US
Practice Address - Phone:573-471-1174
Practice Address - Fax:573-471-1944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044781314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101495802Medicaid
MO265557Medicare PIN