| NPI | 1467449413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SUMMA Administrator 660-562-3515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 031589) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2012-03-28 |