Organization
COUNTRY CLUB CARE CENTER OF WARRENSBURG L C
Active
Other names
Country Club Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE BUNCH (VICE PRESIDENT OF OPERATIONS)
(660) 429-4444
Entity
Organization
Contact information
Practice address
503 REGENT DR, WARRENSBURG, MO 64093-3231
(660) 429-4444
(660) 429-4331
Mailing address
503 REGENT DR, WARRENSBURG, MO 64093-3231
(660) 429-4444
(660) 429-4331
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
035594
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268298007
—
MO
Enumeration date
02/06/2007
Last updated
06/17/2008
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