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Organization

ELDERCARE OF MID-MISSOURI VII, INC.

Active
Other names
StoneBridge Villa Marie
Organization subpart
No

Provider details

NPI number
Authorized official
MARK LIERMAN (AUTHORIZED OFFICIAL)
(636) 477-3280
Entity
Organization

Contact information

Practice address
1030 EDMONDS ST, JEFFERSON CITY, MO 65109-5213
(573) 761-6700
Mailing address
1030 EDMONDS ST, JEFFERSON CITY, MO 65109-5213
(636) 477-3280

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101771905
MO
Enumeration date
05/19/2008
Last updated
12/01/2020
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