Provider Demographics
NPI:1265797278
Name:SILEX NURSING CENTER
Entity type:Organization
Organization Name:SILEX NURSING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHIAS
Authorized Official - Middle Name:PICKETT
Authorized Official - Last Name:DASAL
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:573-384-5213
Mailing Address - Street 1:145 DUNCAN MANSION DR
Mailing Address - Street 2:
Mailing Address - City:SILEX
Mailing Address - State:MO
Mailing Address - Zip Code:63377-2229
Mailing Address - Country:US
Mailing Address - Phone:573-384-1513
Mailing Address - Fax:573-384-1509
Practice Address - Street 1:145 DUNCAN MANSION DR
Practice Address - Street 2:
Practice Address - City:SILEX
Practice Address - State:MO
Practice Address - Zip Code:63377-2229
Practice Address - Country:US
Practice Address - Phone:573-384-1513
Practice Address - Fax:573-384-1509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness