Organization
N & R OF PORTAGEVILLE, INC.
Active
Other names
Portageville Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS HUDSPETH (COO CFO)
(573) 392-0316
Entity
Organization
Contact information
Practice address
290 W STATE HIGHWAY 162, PORTAGEVILLE, MO 63873-9397
(573) 379-2017
(573) 379-2735
Mailing address
PO BOX 408, PORTAGEVILLE, MO 63873-0408
(573) 379-2017
(573) 379-2735
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
030678
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103235008
—
MO
01
—
16877926
STATE ID
MO
Enumeration date
09/22/2005
Last updated
01/21/2009
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