| NPI | 1548394166 |
|---|---|
| Former Legal Business Name | PEACH WOOD MANOR |
| Entity Type | Organization |
| Authorized Contact | LYNDA GAIL DACY Co Owner 417-847-3902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-07-21 |