Organization
VICTORIAN MANOR OF SULLIVAN
Active
Other names
Victorian Manor of Oak Grove/Sullivan
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY QUICK (SECRETARY)
(573) 437-2103
Entity
Organization
Contact information
Practice address
1250 EAST SPRINGFIELD RD, SULLIVAN, MO 63080
(573) 437-2103
(573) 437-2219
Mailing address
1015 SPRINGFIELD RD, OWENSVILLE, MO 65066
(573) 437-2103
(573) 437-2219
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
26324D
MO
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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