Organization
ELDERCARE OF MID-MISSOURI V, INC.
Active
Other names
StoneBridge Lake Ozark
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK LIERMAN (SECRETARY-TREASURER)
(636) 477-3280
Entity
Organization
Contact information
Practice address
872 COLLEGE BLVD, OSAGE BEACH, MO 65065-8408
(573) 302-0900
Mailing address
2500 S OLD HIGHWAY 94, SUITE 104, SAINT CHARLES, MO 63303-5616
(636) 477-3280
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108303207
—
MO
Enumeration date
05/19/2008
Last updated
12/01/2020
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