Organization
CARUTHERSVILLE NO 1 INC
Active
Other names
Southgate Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
500 TRUMAN BLVD, CARUTHERSVILLE, MO 63830-1261
(573) 333-5150
Mailing address
731 N MAIN ST, P. O. BOX 1210, SIKESTON, MO 63801-2151
(573) 471-1276
(573) 472-8504
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
045843
MO
Other
Enumeration date
05/24/2016
Last updated
12/11/2017
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