Provider Demographics
NPI:1679458418
Name:RHODES CREEK HEALTH AND WELLNESS
Entity type:Organization
Organization Name:RHODES CREEK HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:417-434-6369
Mailing Address - Street 1:981 WYCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3320
Mailing Address - Country:US
Mailing Address - Phone:417-434-6369
Mailing Address - Fax:
Practice Address - Street 1:981 WYCKWOOD DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3320
Practice Address - Country:US
Practice Address - Phone:417-434-6369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care