NPI | 1518535285 |
---|---|
Doing Business As | FREDERICK STREET MANOR |
Entity Type | Organization |
Authorized Contact | KEVIN WOOD Owner 573-576-3029 |
Organization Subpart ? | No |
Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
Additional Taxonomies | 310400000X Assisted Living Facility |
Enumeration Date | 2021-06-17 |
Last Update Date | 2021-06-17 |