# NIRMAL K SAMANTA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205168523
- **Authorized official:** NIRMAL KUMAR SAMANTA PHD,CCC-SLP (SPEECH -LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (573) 450-3393

## Contact information

- **Practice address:** 250 BRANDY LN, CAPE GIRARDEAU, MO 63701-8443
- **Practice address phone:** (573) 450-3393
- **Practice address fax:** (573) 339-0911
- **Mailing address:** 250 BRANDY LN, CAPE GIRARDEAU, MO 63701-8443
- **Mailing address phone:** (573) 450-3393
- **Mailing address fax:** (573) 339-0911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | 2004016682 | MO | Yes |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 2004016682 | MO | — |

## Other

- **Enumeration date:** 02/11/2010
- **Last updated:** 02/11/2010