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DIVERSICARE OF CHATEAU LLC NPI 1588079271


NPI Information

NPI: 1588079271
Provider Name: DIVERSICARE OF CHATEAU LLC

Doing Business As: ST. JOSEPH CHATEAU

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 26D0722394

Address:
811 N 9TH ST
SAINT JOSEPH, MO
ZIP 64501
Phone: (816) 233-5164
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DIVERSICARE OF CHATEAU LLC is a nursing facility intermediate care facility in Saint Joseph, MO. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. DIVERSICARE OF CHATEAU LLC NPI is 1588079271. The provider is registered as an organization entity type.
The provider Is Doing Business As St. Joseph Chateau.

The provider's business location address is:

811 N 9TH ST
SAINT JOSEPH, MO
ZIP 64501-651
Phone: (816) 233-5164
Fax: (816) 233-5211

The provider's authorized official is Matthew J Weishaar .
The authorized official title is Cfo And Secretary and has the following contact phone number (615) 771-7575.

The CLIA number assigned to this NPI record is 26D0722394 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2014 and was last updated on 11/7/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1313M00000XNursing Facility/Intermediate Care Facility042612MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11588079271MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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