Organization
N & R OF CRESTVIEW LLC
Active
Other names
Crestview Home
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA HEDRICK CFO (CFO)
(573) 481-9625
Entity
Organization
Contact information
Practice address
1313 SOUTH 25TH STREET, BETHANY, MO 64424
(660) 425-3138
(660) 425-6922
Mailing address
BOX 430, 1313 SOUTH 25TH STREET, BETHANY, MO 64424
(660) 425-3138
(660) 425-6922
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
031793
MO
314000000X
Skilled Nursing Facility
Primary
34647
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101484806
—
MO
Enumeration date
06/23/2006
Last updated
09/15/2025
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