| NPI | 1164404927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM OTKE President/Owner 573-659-6607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MO 030609) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: MO 030608) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2020-08-22 |