Organization
COUNTRY AIRE ESTATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GEORGIA MAY NOLAND (OWNER)
(573) 221-5400
Entity
Organization
Contact information
Practice address
49303 RENSSELAER LN, HANNIBAL, MO 63401-7356
(573) 221-5400
(573) 221-5437
Mailing address
49303 RENSSELAER LN, HANNIBAL, MO 63401-7356
(573) 221-5400
(573) 221-5437
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
018850
MO
Other
Enumeration date
11/21/2006
Last updated
02/03/2015
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