Organization
EXCELSIOR SPRING 1 INC
Active
Other names
Valley Manor & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
1410 HOSPITAL DRIVE, EXCELSIOR SPRINGS, MO 64024
(816) 637-1010
Mailing address
PO BOX 1210, 731 NORTH MAIN STREET, SIKESTON, MO 63801-1210
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
046374
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101455806
—
MO
Enumeration date
07/07/2006
Last updated
01/21/2022
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