City of Adrian - Adrian Manor Health and Rehab
Organization Active NPI Skilled Nursing Facility · Adrian, MO
NPI 1124054366 · NPPES record last updated Jan 13, 2012
Key facts
- NPI
- 1124054366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 030454 (MO)
- Legal business name
- CITY OF ADRIAN - ADRIAN MANOR HEALTH AND REHAB
- Practice address
- 402 W 1St St
Adrian, MO 64720-9998 - Phone
- (816) 297-2107
- Fax
- (816) 297-4321
- NPI assigned
- Jun 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Douglas G Fredrickson
- Title
- Administrator
- Phone
- (816) 297-2107
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 030454 | MO | Yes |
Addresses
Primary practice location
402 W 1St St
Adrian, MO 64720-9998
Mailing address
402 W 1St St
Adrian, MO 64720-9998
Phone (816) 297-2107
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101478907 | Medicaid | MO |
Other providers in Adrian, MO
- Christine Lynn Bohannon
- Brave Blooms Therapy LLC
- Meghan Eileen Brown
- Tiffany Calvert
- Nancy Centlivre
- Hannah Elizabeth Clayton
- D&S Health Partners, LLC
- Erma Louise Davis
- Four Seasons of Adrian, LLC
- George Glenn Gardner
All providers in Adrian, MO · Skilled Nursing Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.