Organization
SHADY LAWN LIVING CENTER, INC
Active
Other names
Shady Lawn Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLENE OSBY (VICE PRESIDENT)
(641) 472-7482
Entity
Organization
Contact information
Practice address
13277 STATE ROUTE D, SAVANNAH, MO 64485-9431
(816) 324-5991
(816) 324-3556
Mailing address
P.O. BOX 277, SAVANNAH, MO 64485-9431
(816) 324-5991
(816) 324-3556
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
040355
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040355
SKILLED NURSING HOME LICENSE NUMBER
MO
05
—
101450302
—
MO
Enumeration date
07/27/2012
Last updated
10/05/2015
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