Organization
MACON COUNTY NURSING HOME DISTRICT
Active
Other names
Loch Haven
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BYRON LYNN FREEMAN (ASSISTANT ADMINISTRATOR)
(660) 385-3113
Entity
Organization
Contact information
Practice address
701 SUNSET HILLS DR, MACON, MO 63552-2165
(660) 385-3113
(660) 385-2838
Mailing address
701 SUNSET HILLS DR, P O BOX 187, MACON, MO 63552-2165
(660) 385-3113
(660) 385-2838
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
030013
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101490001
—
MO
Enumeration date
09/14/2005
Last updated
02/05/2010
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