Organization
N & R OF ODESSA LLC
Active
Other names
NEW HAVEN LIVING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MATHIAS P DASAL (MEMBER)
(573) 481-9625
Entity
Organization
Contact information
Practice address
609 GOLF ST, ODESSA, MO 64076-1462
(816) 230-7530
(816) 633-7661
Mailing address
609 GOLF ST, ODESSA, MO 64076-1462
(816) 230-7530
(816) 633-7661
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
043407
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101492205
—
MO
Enumeration date
08/18/2016
Last updated
08/18/2016
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