Provider Demographics
NPI:1700871365
Name:WEBSTER COUNTY NURSING HOME DISTRICT
Entity Type:Organization
Organization Name:WEBSTER COUNTY NURSING HOME DISTRICT
Other - Org Name:WEBCO NURSING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-859-5144
Mailing Address - Street 1:1687 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65706-2325
Mailing Address - Country:US
Mailing Address - Phone:417-859-5144
Mailing Address - Fax:417-468-2562
Practice Address - Street 1:1687 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MO
Practice Address - Zip Code:65706-2325
Practice Address - Country:US
Practice Address - Phone:417-859-5144
Practice Address - Fax:417-468-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO031442314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101497709Medicaid
MO0241850001OtherDMERC
MO101497709Medicaid