| NPI | 1487066650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUE DE LA PIEDRA Owner 573-897-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 042107) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2014-07-09 |