Organization
THE VILLAS OF JACKSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL MARTIN KNOTT LNHA (ADMINISTRATOR)
(573) 986-8210
Entity
Organization
Contact information
Practice address
670 BROADRIDGE, JACKSON, MO 63755
(573) 986-8210
(573) 755-5155
Mailing address
670 BROADRIDGE, JACKSON, MO 63755
(573) 986-8210
(573) 755-5155
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
045129
MO
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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