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Contact Information

DESOTO RESIDENTIAL CARE APTS INC
1550 VILLAS DRIVE
DE SOTO, MO63020-2586
 Phone: 636-586-6559
 Fax: 636-586-1604
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for DESOTO RESIDENTIAL CARE APTS INC

NPI Number 1972586659
LBN Legal business name DESOTO RESIDENTIAL CARE APTS INC
Authorized official TOM OTKE - (PRESIDENT OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/28/2005
Last updated 06/30/2008 - About 18 years ago
Identifiers
MO License # 031260
MO License # 031261
MO Medicaid 107812307
MO Medicaid 266751809
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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