| NPI | 1194806109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARO SHIRSHEKAN Managing Member 573-701-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 031651) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2013-12-17 |