Provider Demographics
NPI:1982019790
Name:N & R OF NEVADA LLC
Entity Type:Organization
Organization Name:N & R OF NEVADA LLC
Other - Org Name:NEVADA NURSING & REHAB
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:573-481-9625
Mailing Address - Street 1:700 E HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-1025
Mailing Address - Country:US
Mailing Address - Phone:417-667-8889
Mailing Address - Fax:417-667-7830
Practice Address - Street 1:700 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-1025
Practice Address - Country:US
Practice Address - Phone:417-667-8889
Practice Address - Fax:417-667-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO040601314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO106773807Medicaid
MO265558Medicare Oscar/Certification