| NPI | 1932323508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX C KROEGER Owner 660-826-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: MO 033746) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |