Diversicare of Chateau LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

042612 Issued in MO

Legal business name

DIVERSICARE OF CHATEAU LLC

Practice address

811 N 9TH St
Saint Joseph, MO 64501-1651

Phone

(816) 233-5164

Fax

(816) 233-5211

NPI assigned

Jun 22, 2014

Organization subpart

Yes

Parent organization

DIVERSICARE HEALTHCARE SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Matthew J Weishaar

Title

Cfo and Secretary

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Joseph Chateau Doing business as

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

{
    "created_epoch": "1403395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1588079271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N 9TH ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645011651",
            "telephone_number": "816-233-5164",
            "fax_number": "816-233-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N 9TH ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645011651",
            "telephone_number": "816-233-5164",
            "fax_number": "816-233-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE OF CHATEAU LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVERSICARE HEALTHCARE SERVICES LLC",
        "enumeration_date": "2014-06-22",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A",
        "authorized_official_last_name": "WEISHAAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO AND SECRETARY",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MO",
            "license": "042612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588079271",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Chateau",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Joseph Chateau",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Dickson
• Elena Dimiceli, M.D.
• Frederick Dimmel III, CRNA
• Kylie Dishman
• Kaley Irene Dittemore
• Diversicare of Riverside, LLC
• Diversicare of St. Joseph, LLC
• Alexa Dixon
• Charles W Dobbs, MD
• Dennis Charles Dobyan, MD

• Nursing Facility/Intermediate Care Facility in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Nursing Facility/Intermediate Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.