Organization
LAVERNA VILLAGE NURSING HOME INC.
Active
Parent organization
PLATINUM HEALTH CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
PLATINUM HEALTH CARE
Authorized official
MR. ROSS P MARINE (ADMINISTRATOR)
(816) 324-3185
Entity
Organization
Contact information
Practice address
904 HALL AVENUE, SAVANNAH, MO 64485-0279
(816) 324-3185
(816) 324-4097
Mailing address
PO BOX 279, SAVANNAH, MO 64485-0279
(816) 324-3185
(816) 324-4097
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
034371
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265787
MEDICARE PROVIDER #
MO
Enumeration date
10/02/2006
Last updated
07/12/2007
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