Organization
DADE COUNTY NURSING HOME DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRIESHA ANN HUDDLESTON (ADMINISTRATOR)
(417) 637-5315
Entity
Organization
Contact information
Practice address
400 BROAD ST, GREENFIELD, MO 65661-1405
(417) 637-5315
(417) 637-5281
Mailing address
400 BROAD ST, GREENFIELD, MO 65661-1405
(417) 637-5315
(417) 637-5281
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031395
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101485001
—
MO
Enumeration date
10/11/2005
Last updated
02/21/2012
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