Organization
BENCHMARK HEALTHCARE OF LOMA LINDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN M SELLS (MANAGER)
(636) 449-1795
Entity
Organization
Contact information
Practice address
1600 E ROLLINS ST, MOBERLY, MO 65270-2478
(660) 263-6887
(660) 263-8823
Mailing address
17826 EDISON AVE, CHESTERFIELD, MO 63005-1262
(636) 449-1794
(636) 536-4533
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
PENDING
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102385002
—
MO
Enumeration date
02/28/2011
Last updated
11/08/2013
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