Organization
PRAIRIE VIEW SKILLED NURSING LLC
Active
Other names
Prairie View Skilled Nursing
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN P SELLS (CEO)
(573) 703-3049
Entity
Organization
Contact information
Practice address
606 W MISSOURI ST, BLOOMFIELD, MO 63825-9706
(573) 568-2137
(573) 568-9906
Mailing address
606 W MISSOURI ST, BLOOMFIELD, MO 63825-9706
(573) 568-2137
(573) 568-9906
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101456002
—
MO
Enumeration date
08/17/2016
Last updated
04/08/2024
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