Provider Demographics
NPI:1902660467
Name:THE BAPTIST HOME
Entity Type:Organization
Organization Name:THE BAPTIST HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-556-0338
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65102-0397
Mailing Address - Country:US
Mailing Address - Phone:573-556-0338
Mailing Address - Fax:
Practice Address - Street 1:1625 W GARTON RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-6637
Practice Address - Country:US
Practice Address - Phone:417-581-2101
Practice Address - Fax:417-581-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility