| NPI | 1710192315 |
|---|---|
| Other Name | BRISTOL MANOR OF BOONVILLE |
| Entity Type | Organization |
| Authorized Contact | SHELLEY DEANNE EBELING Medicaid Billing Department 660-826-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-10-02 |