Provider Demographics
NPI:1770590812
Name:KABUL NURSING HOMES INC
Entity type:Organization
Organization Name:KABUL NURSING HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF DIRECTORS PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:COATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-962-3713
Mailing Address - Street 1:1000 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CABOOL
Mailing Address - State:MO
Mailing Address - Zip Code:65689-9125
Mailing Address - Country:US
Mailing Address - Phone:417-962-3713
Mailing Address - Fax:417-962-4947
Practice Address - Street 1:1000 MAIN ST
Practice Address - Street 2:
Practice Address - City:CABOOL
Practice Address - State:MO
Practice Address - Zip Code:65689-9125
Practice Address - Country:US
Practice Address - Phone:417-962-3713
Practice Address - Fax:417-962-4947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO030908314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO26-5055OtherOSCAR
MO101488500Medicaid
MO26-5055OtherOSCAR
MO101488500Medicaid
MO0600650001Medicare NSC