Organization
CHRISTIAN HEALTH CARE OF LEBANON NORTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS STAYTON (PRESIDENT)
(417) 891-9939
Entity
Organization
Contact information
Practice address
596 MORTON RD, LEBANON, MO 65536-3648
(417) 532-9173
(417) 532-8223
Mailing address
222 S 1ST ST, ROGERS, AR 72756-4504
(479) 464-0200
(479) 464-8098
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
032279
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101489409
—
MO
Enumeration date
10/02/2006
Last updated
12/20/2011
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