| NPI | 1629128970 |
|---|---|
| Other Name | MAGNOLIA |
| Entity Type | Organization |
| Authorized Contact | PAUL EWERT Chief Executive Officer 573-221-2258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |