Organization
BERTHOLD NURSING CENTER INC
Active
Other names
Oak Park Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFF SHIRRELL (VICE PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
6637 BERTHOLD AVE, SAINT LOUIS, MO 63139-3318
(314) 781-3444
(314) 781-6139
Mailing address
731 N MAIN ST, P.O. BOX 1210, SIKESTON, MO 63801-2151
(573) 471-1276
(573) 472-8504
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
040704
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102561503
—
MO
Enumeration date
07/07/2006
Last updated
01/03/2017
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