Organization
NORTHPORT HEALTH SERVICES OF MISSOURI, LLC
Active
Other names
Carthage Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CODY LONG (CFO)
(205) 391-3600
Entity
Organization
Contact information
Practice address
1901 BUENA VISTA AVE, CARTHAGE, MO 64836-3178
(417) 358-1937
Mailing address
1901 BUENA VISTA AVE, CARTHAGE, MO 64836-3178
(417) 358-1937
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102282803
—
MO
Enumeration date
05/25/2006
Last updated
10/09/2020
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