Northeastern Nursing & Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NORTHEASTERN NURSING & REHABILITATION CENTER LLC

Practice address

2600 Redman Rd
Saint Louis, MO 63136-5863

Phone

(314) 355-8585

Fax

(314) 355-4645

NPI assigned

Dec 8, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Robert G Hedges

Title

Managing Member of LLC

Phone

(217) 528-2244

Specialties & licenses 1

Addresses

Other names 1

• Willowbrooke Nursing & Rehabilitation Center Doing business as

Locations

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267401600000",
    "number": "1891024691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032828",
            "telephone_number": "217-528-2244",
            "fax_number": "217-528-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 REDMAN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631365863",
            "telephone_number": "314-355-8585",
            "fax_number": "314-355-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN NURSING & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2010-03-01",
        "status": "A",
        "authorized_official_last_name": "HEDGES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING MEMBER OF LLC",
        "authorized_official_telephone_number": "217-528-2244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willowbrooke Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Side Foot Clinic P.C.
• North Valley Nursing & Rehabilitation Center LLC
• Karen Suzanne Northcott, MSW, LCSW
• Amanda Lee Northcutt, PLPC
• Northeast Ambulance and Fire Protection District
• Northern Family Adult Daycare LLC
• Northern Family Home Health Care LLC
• Northern Family in Home Services LLC
• Northland Hearing Center Inc
• Northland Hearing Center, Inc.

• Skilled Nursing Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; 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.