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Organization

KENNETT RESIDENTIAL CARE FACILITY II INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GINA DAWN STOVERINK (OWNER PRESIDENT)
(573) 888-1201
Entity
Organization

Contact information

Practice address
919 S JACKSON ST, KENNETT, MO 63857-3803
(573) 888-1201
(573) 888-0114
Mailing address
919 S JACKSON ST, KENNETT, MO 63857-3803
(573) 888-1201
(573) 888-0114

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
032637
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
266730803
MO
Enumeration date
03/23/2007
Last updated
07/07/2008
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