ELDERCARE OF MID-MISSOURI IV, INC. (NPI# 1487811436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487811436 |
| Entity Type | Organization |
| Organization Name | ELDERCARE OF MID-MISSOURI IV, INC. |
| Other Organization Name | THE VILLAS - A STONEBRIDGE COMMUNITY |
| Practice Address |
1550 Villa Dr De Soto MO 63020-2586 |
| Practice Telephone | 6365866559 |
| Mailing Telephone | 6364773280 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2014-06-16 |
| Authorized Official Name | MR. MARK LIERMAN (SECRETARY - TREASURER) |
| Authorized Official Telephone | 6364773280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251J00000X | Nursing Care | 035678 | MO | Agencies |
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 107812307 | 05 |
| Other Name | Type Code |
|---|---|
| The Villas - A StoneBridge Community | Doing Business As Name - Organization |
| Street Address |
1550 VILLA DR |
| City | DE SOTO |
| State | MO |
| Zip Code | 63020-2586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548399272 | Desoto Residential Care Apts, Inc. | Nursing Facility/Intermediate Care Facility | 1550 Villa Dr, De Soto, MO 63020-2586 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700435385 | Patsy Maness | Technician | 5100 Knorpp Road, De Soto, MO 63020 | 2019-09-06 |
| 1013268911 | Jane Susann Brenneke | Counselor | 116 B 2nd Street, Desoto, MO 63020 | 2012-10-02 |
| 1477634277 | Wal-mart Stores East, Lp | Technician/Technologist | 12862 State Road 21, De Soto, MO 63020 | 2006-10-18 |
| 1235109877 | John W Dickinson | Dentist | 704 N Main Street, Desoto, MO 63020 | 2006-01-25 |
| 1700883253 | Valle Ambulance District | Ambulance | 12363 State Route 21, De Soto, MO 63020 | 2005-06-30 |
| 1568893105 | Terence A. Friskel | Dentist | 110 North Main, Desoto, MO 63020 | 2013-12-09 |
| 1457541427 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12977 State Route 21, De Soto, MO 63020-1000 | 2007-07-26 |
| 1982880084 | Thomas L. Monje, O.d. | Optometrist | 26 Jefferson Sq, De Soto, MO 63020-1031 | 2008-01-18 |
| 1548266737 | Steven Crawford | Family Medicine | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2005-06-22 |
| 1720595200 | Danielle Marie Howerton | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2018-01-05 |
| Find all providers in zip 63020 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134115454 | Hillcrest Care Center, Inc. | Skilled Nursing Facility | 1108 Clarke St, De Soto, MO 63020-2706 | 2005-09-22 |
| 1922094523 | Bb&k, Inc. | Skilled Nursing Facility | 3260 Baisch Dr, De Soto, MO 63020-5046 | 2005-09-20 |
| 1851844393 | Desoto Investment Group LLC | Skilled Nursing Facility | 3260 Baisch Dr, De Soto, MO 63020-5046 | 2016-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609492719 | Ignite Medical Resort Independence LLC | Skilled Nursing Facility | 20511 E. Trinity Pl., Blue Springs, MO 64015 | 2020-06-24 |
| 1760006308 | Sunterra Dardenne Prairie Oc LLC | Skilled Nursing Facility | 7275 Highway N, Dardenne Prairie, MO 63368-7126 | 2020-05-29 |
| 1184247215 | Berry Medical Properties, LLC | Skilled Nursing Facility | 11380 Natural Bridge Rd, Bridgeton, MO 63044-2307 | 2020-05-23 |
| 1881249464 | Rolla Grand LLC | Skilled Nursing Facility | 1800 White Columns Dr, Rolla, MO 65401-2044 | 2019-08-09 |
| 1184276982 | Willow Health Care Inc | Skilled Nursing Facility | 712 Copper Rock Dr, Rogersville, MO 65742-8970 | 2019-07-11 |
| 1548734627 | Medicore Medical Service LLC | Skilled Nursing Facility | 2303 Kratky Rd Apt B, Saint Louis, MO 63114-1783 | 2019-01-11 |
| 1518436724 | Missouri Nursing & Rehab LLC | Skilled Nursing Facility | 783 Weber Road, Farmington, MO 63640-3318 | 2018-11-16 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1578039467 | Laverna Senior Living LLC | Skilled Nursing Facility | 904 S Hall Ave, Savannah, MO 64485-1952 | 2018-10-17 |
| 1093297152 | Community Care Center of Union Inc | Skilled Nursing Facility | 1080 Marie Lane, Union, MO 63084 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ELDERCARE OF MID-MISSOURI IV, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.