| NPI | 1356539696 |
|---|---|
| Doing Business As | COLUMBIA STREET MANOR |
| Entity Type | Organization |
| Authorized Contact | ELANE JOHNSON Administrator 573-760-9376 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |