Organization
VIENNA NURSING & REHAB LLC
Active
Other names
Maries Manor
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA HEDRICK CFO (CFO)
(573) 481-9625
Entity
Organization
Contact information
Practice address
174 BALLPARK ROAD, VIENNA, MO 65582-8043
(573) 422-3177
(573) 422-3079
Mailing address
174 BALLPARK RD, VIENNA, MO 65582-8043
(573) 422-3177
(573) 422-3079
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
028504
MO
314000000X
Skilled Nursing Facility
Primary
035364
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102018900
—
MO
Enumeration date
02/17/2006
Last updated
09/15/2025
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