Four Seasons Living Center, LLC

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Legal business name

FOUR SEASONS LIVING CENTER, LLC

Practice address

2800 Highway TT
Sedalia, MO 65301-1410

Phone

(660) 826-8803

Fax

(660) 826-6864

NPI assigned

Mar 1, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Joseph Destefane

Title

President

Phone

(314) 543-3800

Specialties & licenses 1

Addresses

Tax ID family

Four Seasons Living Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Four Seasons Living Center, LLC

  • Skilled Nursing Facility
  • Sedalia, MO
  • NPI 1538157367
  NPD tax ID

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699803999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 HIGHWAY TT",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653011410",
            "telephone_number": "660-826-8803",
            "fax_number": "660-826-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 HIGHWAY TT",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653011410",
            "telephone_number": "660-826-8803",
            "fax_number": "660-826-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS LIVING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESTEFANE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-543-3800"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett Audrey Fizer, PROVISIONAL LBA
• Brandon Keith Fletcher, PT, DPT, ATC
• Molly Foster, DMD
• Robert Stephen Foster, M.D.
• Four Seasons Living Center, LLC
• Four Seasons SNF Opco LLC (Four Seasons Living Center)
• Philip J Fracica, M.D.
• Frankum Family Dentistry Lindell N Frankum D.D.S.,P.C. (Frankum Family Dentistry)
• Lindell Neal Frankum, D.D.S.
• Thelma Guadalupe Frankum, D.D.S.

• Nurse's Aide in Sedalia, MO
• Providers in Sedalia, MO by specialty
• Nurse's Aide in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.