Green Acres Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GREEN ACRES ASSISTED LIVING LLC

Practice address

411 N Kings Highway
Sikeston, MO 63801-1936

Phone

(573) 471-0466

Fax

(573) 471-4918

NPI assigned

Aug 12, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terry Cole

Title

Owner

Phone

(573) 471-0466

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1366053480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E MALONE AVE",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638013413",
            "telephone_number": "573-471-0466",
            "fax_number": "573-471-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N KINGS HIGHWAY",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011936",
            "telephone_number": "573-471-0466",
            "fax_number": "573-471-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN ACRES ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-471-0466"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Glueck, PTA
• Karen Denise Gordon
• Timothy D. Gould, ED.D LPC
• Amber Graham
• Randee Grant
• Green Meadows
• Anita Kay Green, LCSW
• Teresa Diane Green
• Cortney D Griffin, DPT, PT
• Lois Kay Griffin, RNC-WHNP

• All providers in Sikeston, MO
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.