Shady Lawn Living Center, Inc
Organization Active NPI Skilled Nursing Facility · Savannah, MO
NPI 1295081222 · NPPES record last updated Oct 5, 2015
Key facts
- NPI
- 1295081222
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 040355 (MO)
- Legal business name
- SHADY LAWN LIVING CENTER, INC
- Practice address
- 13277 State Route D
Savannah, MO 64485-9431 - Phone
- (816) 324-5991
- Fax
- (816) 324-3556
- NPI assigned
- Jul 27, 2012
- Organization subpart
- No
Authorized official
- Name
- Ms. Charlene Osby
- Title
- Vice President
- Phone
- (641) 472-7482
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 040355 | MO | Yes |
Addresses
Primary practice location
13277 State Route D
Savannah, MO 64485-9431
Mailing address
P.O. Box 277
Savannah, MO 64485-9431
Phone (816) 324-5991
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101450302 | Medicaid | MO | |
| 040355 | Other | MO | SKILLED NURSING HOME LICENSE NUMBER |
Other names
- Shady Lawn Living Center
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- Casey M Samples
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All providers in Savannah, 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 Oct 5, 2015. 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.