Organization
VILLAGE CARE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY SUMMA (ADMINISTRATOR)
(660) 562-3515
Entity
Organization
Contact information
Practice address
810 E EDWARDS ST, MARYVILLE, MO 64468-2917
(660) 562-3515
(660) 562-3658
Mailing address
810 E EDWARDS ST, MARYVILLE, MO 64468-2917
(660) 562-3515
(660) 562-3658
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031589
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108108101
—
MO
Enumeration date
10/04/2005
Last updated
03/28/2012
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