Organization
EBG HEALTH CARE I, INC.
Active
Other names
Garrison Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL L GOURLEY (CHIEF FINANCIAL OFFICER)
(417) 869-5522
Entity
Organization
Contact information
Practice address
2939 MAGAZINE ST, SAINT LOUIS, MO 63106-1245
(314) 531-0500
(314) 531-5455
Mailing address
1505 E TRAFFICWAY ST, SPRINGFIELD, MO 65802-3174
(417) 869-5522
(417) 831-7729
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
033709
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102710704
—
MO
Enumeration date
04/12/2007
Last updated
06/24/2014
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