Provider Demographics
NPI:1295325843
Name:OWEN ACRES LLC
Entity type:Organization
Organization Name:OWEN ACRES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:LEEANN
Authorized Official - Last Name:SWITZER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:573-718-3885
Mailing Address - Street 1:614 COUNTY ROAD 466
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-2964
Mailing Address - Country:US
Mailing Address - Phone:573-778-0497
Mailing Address - Fax:573-785-9509
Practice Address - Street 1:614 COUNTY ROAD 466
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-2964
Practice Address - Country:US
Practice Address - Phone:573-778-0497
Practice Address - Fax:573-785-9509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility