Organization
HUBBLE CREEK, LLC
Active
Other names
Monticello House
Organization subpart
No
Provider details
NPI number
Authorized official
BEN PACK SELLS (CEO)
(573) 703-3049
Entity
Organization
Contact information
Practice address
1115 K LAND DRIVE, JACKSON, MO 63755
(573) 243-8989
(573) 243-6836
Mailing address
300 N WALNUT ST STE A, DEXTER, MO 63841-1748
(573) 614-7472
(573) 243-6836
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031404
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105214902
—
MO
01
—
16950101
STATE ID
MO
Enumeration date
09/22/2005
Last updated
01/12/2026
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