Organization
STELLBROOK MANAGEMENT, LLC
Active
Other names
The Colonial Home
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB HOGG (ADMINISTRATOR)
(573) 712-2992
Entity
Organization
Contact information
Practice address
102 E SUMMIT ST, DONIPHAN, MO 63935-1328
(573) 712-2992
Mailing address
1321 W MAUD ST, POPLAR BLUFF, MO 63901-4819
(157) 371-2299
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/26/2021
Last updated
11/28/2021
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