Organization
KIRKSVILLE MANOR INC
Active
Other names
Kirksville Manor Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAL JUCKETTE (DIRECTOR OF OPERATIONS)
(660) 646-5385
Entity
Organization
Contact information
Practice address
1705 E LAHARPE ST, KIRKSVILLE, MO 63501-3927
(660) 665-3774
(660) 627-1991
Mailing address
1705 E LAHARPE ST, KIRKSVILLE, MO 63501-3927
(660) 665-3774
(660) 627-1991
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
017422
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102020500
—
MD
Enumeration date
09/13/2006
Last updated
06/29/2012
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