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Organization

BUCKEYE J, LLC

Active
Other names
Jackson Manor Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
JAY MOSKOWITZ (PRESIDENT)
(303) 238-3838
Entity
Organization

Contact information

Practice address
710 BROADRIDGE DR, JACKSON, MO 63755-3042
(573) 243-3101
(573) 243-6742
Mailing address
12136 W BAYAUD AVE, SUITE 200, LAKEWOOD, CO 80228-2115
(303) 238-3838
(303) 987-0434

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031659
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101456606
MO
Enumeration date
11/01/2005
Last updated
04/25/2016
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