Organization
INDIAN HILLS RETIREMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM OTKE (PRESIDENT/OWNER)
(573) 659-6607
Entity
Organization
Contact information
Practice address
2601 FAIR ST, CHILLICOTHE, MO 64601-3525
(660) 646-1230
(660) 707-1198
Mailing address
2601 FAIR ST, CHILLICOTHE, MO 64601-3525
(660) 646-1230
(660) 707-1198
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
031645
MO
314000000X
Skilled Nursing Facility
Primary
031645
MO
Other
Enumeration date
11/17/2005
Last updated
02/29/2008
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