# CITIZENS MEMORIAL HEALTH CARE FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Citizens Memorial Home Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376672238
- **Authorized official:** GARY D. FULBRIGHT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (417) 328-6501

## Contact information

- **Practice address:** 111 W BROADWAY ST, BOLIVAR, MO 65613-1501
- **Practice address phone:** (417) 328-6350
- **Practice address fax:** (417) 328-6987
- **Mailing address:** 1500 N OAKLAND AVE, BOLIVAR, MO 65613-3099
- **Mailing address phone:** (417) 326-6000
- **Mailing address fax:** (417) 328-6237

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 2-22 | MO | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 02/18/2020