VICTORIAN MANOR OF SULLIVAN (NPI# 1407099500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407099500 |
Entity Type | Organization |
Organization Name | VICTORIAN MANOR OF SULLIVAN |
Other Organization Name | VICTORIAN MANOR OF OAK GROVE/SULLIVAN |
Practice Address |
1250 East Springfield Rd Sullivan MO 63080 |
Mailing Address |
1015 Springfield Rd Owensville MO 65066 |
Practice Telephone | 5734372103 |
Practice Fax Number | 5734372219 |
Mailing Telephone | 5734372103 |
Mailing Fax Number | 5734372219 |
Enumeration Date | 2009-04-20 |
Last Update Date | 2009-04-20 |
Authorized Official Name | NANCY QUICK (SECRETARY) |
Authorized Official Telephone | 5734372103 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | 26324D | MO | Nursing & Custodial Care Facilities |
Other Name | Type Code |
---|---|
Victorian Manor of Oak Grove/Sullivan | Doing Business As Name - Organization |
Street Address |
1250 EAST SPRINGFIELD RD |
City | SULLIVAN |
State | MO |
Zip Code | 63080 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669896650 | Lindsay Nicole Arnette | Physical Therapist | 940 Mattox Drive, Meramec Nursing Center, Sullivan, MO 63080 | 2014-02-11 |
1578729992 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 123 Progress Parkway, Sullivan, MO 63080 | 2008-08-05 |
1386826089 | Sellers Family Chiropractic PC | Chiropractor | 405 Wal Mart Drive, Sullivan, MO 63080 | 2007-12-04 |
1740495282 | Tasha Marie Rodriguez | Physical Therapist | 107 Congress Dr., Sullivan, MO 63080 | 2007-05-10 |
1033261649 | Clyde William Sellers II | Chiropractor | 405 Walmart Dr., Sullivan, MO 63080 | 2007-01-17 |
1407954209 | Sara Skidmore | Occupational Therapist | 2022 Phoenix Drive, Sullivan, MO 63080 | 2006-09-20 |
1083724116 | Sharon A Titter | Physical Therapist | 107 Progress Dr, Sullivan, MO 63080 | 2006-08-30 |
1437135571 | Thanh Duy Vo | Pediatrics | 486 N Church St, Sullivan, MO 63080 | 2005-12-20 |
1508849316 | Air Evac Ems Inc | Ambulance | 673 Sappington Bridge Rd, Sullivan, MO 63080 | 2005-11-25 |
1790205656 | Melissa Leigh Hildebrandt | Counselor | 101 Progress Pkwy, Sullivan, MO 63080 | 2017-06-22 |
Find all providers in zip 63080 |
Taxonomy Code | 310400000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164055323 | Cye Sullivan Hco, LLC | Assisted Living Facility | 20 Courtyard Blvd, Sullivan, IL 61951-7001 | 2020-02-17 |
1730552811 | Magnolia Health Systems 49, LLC | Assisted Living Facility | 2009 N Hospital Blvd, Sullivan, IN 47882-7658 | 2015-11-11 |
1386980068 | Americare At Victorian Manor of Sullivan, LLC | Assisted Living Facility | 1250 E Springfield Rd, Sullivan, MO 63080-1358 | 2012-12-27 |
1598918385 | Petersen Health Care II, Inc. | Assisted Living Facility | 20 Courtyard Boulevard, Sullivan, IL 61951-7001 | 2008-10-24 |
1588798995 | Alternatives Care System, Inc. | Assisted Living Facility | 2665 N Service Rd E, Sullivan, MO 63080-4024 | 2007-03-15 |
1447206768 | Sullivan Residential, LLC | Assisted Living Facility | 775 Dunsford Dr, Sullivan, MO 63080-1270 | 2006-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144820283 | Oak Meadows Rcf LLC | Assisted Living Facility | 5502 Misty Meadow Rd, Poplar Bluff, MO 63901-9287 | 2020-10-28 |
1700486859 | Hillcrest Residential Care | Assisted Living Facility | 9415 N North Browns Station Rd, Columbia, MO 65202-8671 | 2020-10-28 |
1700484250 | Americare At Field Pointe LLC | Assisted Living Facility | 5002 Gene Field Road, St Joseph, MO 64506 | 2020-10-15 |
1205433638 | Skyline Assisted Living LLC | Assisted Living Facility | 100 Hard Rock Rd, Van Buren, MO 63965-0780 | 2020-10-08 |
1023615622 | Four Seasons Care Corp | Assisted Living Facility | 230 Railroad St, Moscow Mills, MO 63362-1600 | 2020-10-06 |
1336754985 | Tiffany Springs Senior Care Community | Assisted Living Facility | 9101 N Ambassador Dr, Kansas City, MO 64154-7295 | 2020-09-10 |
1366053480 | Green Acres Assisted Living LLC | Assisted Living Facility | 411 N Kings Highway, Sikeston, MO 63801-1936 | 2020-08-12 |
1467062612 | Welcome Home Assisted Living, LLC | Assisted Living Facility | 5 Adams Dr, Dexter, MO 63841-1985 | 2020-08-03 |
1831725142 | Harmony Gardens Residential, LLC | Assisted Living Facility | 539 E Young Ave, Warrensburg, MO 64093-1228 | 2020-03-18 |
1386278414 | Family Partners Home LLC | Assisted Living Facility | 232 Creve Coeur Ave, Manchester, MO 63011-4040 | 2020-02-27 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.