Organization
DIVERSICARE OF ST. JOSEPH, LLC
Active
Parent organization
DIVERSICARE LEASING COMPANY II, LLC
Other names
Diversicare of St. Joseph
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE LEASING COMPANY II, LLC
Authorized official
MATTHEW J WEISHAAR (CFO AND SECRETARY)
(615) 550-9459
Entity
Organization
Contact information
Practice address
3002 N 18TH ST, SAINT JOSEPH, MO 64505-1872
(816) 364-4200
(816) 364-4283
Mailing address
3002 N 18TH ST, SAINT JOSEPH, MO 64505-1872
(816) 364-4200
(816) 364-4283
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
042463
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831504521
—
MO
Enumeration date
06/22/2014
Last updated
10/21/2022
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