Organization
PEARL'S II EDEN FOR ELDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY CHERYLE BAGLEY (ADMINISTRATOR)
(660) 748-4407
Entity
Organization
Contact information
Practice address
611 N COLLEGE AVE, PRINCETON, MO 64673-1051
(660) 748-4407
(660) 748-4409
Mailing address
611 N COLLEGE AVE, PRINCETON, MO 64673-1051
(660) 748-4407
(660) 748-4409
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031116
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101493708
—
MO
01
—
265796
OSCAR
MO
Enumeration date
11/07/2005
Last updated
03/26/2012
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