Organization
N & R OF SPRINGFIELD MONTCLAIR LLC
Active
Other names
Springfield Villa
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA HEDRICK CFO (CFO)
(573) 481-9625
Entity
Organization
Contact information
Practice address
1100 E MONTCLAIR ST, SPRINGFIELD, MO 65807-5076
(417) 820-8500
(417) 820-8503
Mailing address
1100 E MONTCLAIR ST, SPRINGFIELD, MO 65807-5076
(417) 820-8500
(417) 820-8503
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
043573
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107807604
—
MO
Enumeration date
04/17/2017
Last updated
09/16/2025
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