| NPI | 1831535301 |
|---|---|
| Doing Business As | KEITH STREET MANOR |
| Entity Type | Organization |
| Authorized Contact | DAPHNE ILENE MCDONALD LLC Member 573-518-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2013-05-10 |