Organization
PLEASANT VALLEY MANOR INC
Active
Other names
Pleasant Valley 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
6814 SOBBIE ROAD, LIBERTY, MO 64068
(816) 781-5277
(816) 781-8273
Mailing address
6814 SOBBIE ROAD, LIBERTY, MO 64068
(816) 781-5277
(816) 781-8273
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
016612
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107811804
—
MO
Enumeration date
09/13/2006
Last updated
07/25/2012
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