Organization
SPRING RIVER CHRISTIAN VILLAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN MCGHEE (CHIEF FINANCIAL OFFICER)
(314) 587-7903
Entity
Organization
Contact information
Practice address
201 S NORTHPARK LN, JOPLIN, MO 64801-8426
(417) 623-4313
(417) 623-5478
Mailing address
201 S NORTHPARK LN, JOPLIN, MO 64801-8426
(417) 623-4313
(417) 623-5478
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
032600
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102515806
—
MO
01
—
154310
BCBS PROVIDER NUMBER
MO
01
—
701881
BCBS PROVIDER NUMBER
KS
Enumeration date
07/18/2006
Last updated
12/12/2013
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