| NPI | 1255436556 |
|---|---|
| Doing Business As | INDEPENDENCE MANOR CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | HAL JUCKETTE Owner 660-646-5385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 002374) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2012-07-05 |