| NPI | 1902265986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA KAY JOHNSON Owner/Manager 573-265-6004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2016-02-18 |
| Last Update Date | 2016-02-18 |