Sturgeon Rest Home, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

043145 Issued in MO

Legal business name

STURGEON REST HOME, LLC

Practice address

315 E Stone St
Sturgeon, MO 65284-8907

Phone

(573) 687-3012

Fax

(573) 687-1250

NPI assigned

Nov 1, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Daniel R. Prevo

Title

Owner

Phone

(573) 818-8385

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1487930731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 HIGHWAY 63 S",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018995",
            "telephone_number": "573-818-8385",
            "fax_number": "573-687-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E STONE ST",
            "city": "STURGEON",
            "state": "MO",
            "postal_code": "652848907",
            "telephone_number": "573-687-3012",
            "fax_number": "573-687-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STURGEON REST HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "PREVO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-818-8385",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MO",
            "license": "043145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personalized Counseling of Mid-Missouri LLC
• Roger a Martin
• Janice Kay Skinner, MA SLP CCC
• Sturgeon Medical Clinic PC
• Sturgeon R-V School
• Sturgeon Rest Residential Care LLC
• Tri County Medical Clinic P C
• Alan M Weaver, D.O.

• Custodial Care Facility in Sturgeon, MO
• Providers in Sturgeon, MO by specialty
• Custodial Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.