NPI | 1831187152 |
---|---|
Doing Business As | FOUNTAINBLEAU LODGE |
Entity Type | Organization |
Authorized Contact | SHAFIQ M MALIK President 573-335-1999 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 030982) |
Enumeration Date | 2005-10-11 |
Last Update Date | 2020-08-22 |