OrganizationActive
Life Enhancement Village of Branson
NPI 1689842916 · Assisted Living Facility (Mental Illness) · Walnut Shade, MO
Provider details
- NPI number
- 1689842916
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Mental Illness)Nursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Kenny Rogers, Ceo(417) 725-6680
- License
- 0328545 (MO)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
421 Oak Ridge Rd
Walnut Shade, MO 65771-9173
Phone: (417) 561-5395
Fax: (417) 561-5395
Approximate (ZIP-level) locationGet directions
Mailing address
421 Oak Ridge Rd
Walnut Shade, MO 65771-9173
Registry dates
- Enumerated
- 2008-02-20
- Last updated
- 2008-02-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.