| NPI | 1770078263 |
|---|---|
| Doing Business As | MEDILODGE AT THE SHORE |
| Entity Type | Organization |
| Authorized Contact | KRISTINE RANEL KIRK Delegated Official 417-846-3521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2026-05-28 |