| Organization Name: | PUTNAM COUNTY NURSING HOME |
| NPI Number: | 1881835528 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PASSION R WYANT (ADMINISTRATOR) |
| Mailing Address: | 1814 Oak St Unionville |
| State: | MO US |
| Postal Code: | 635651275 |
| Phone Number: | 6609472492 |
| Fax Number: | |
| NPI Enumeration Date: | 03/10/2009 |
| NPI Last Update Date: | 03/10/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | 06516 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |