Organization
FAITH HOSPICE OF THE OZARKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLA RAE MANARY RN, CHPN (ADMINISTRATOR/OWNER)
(417) 840-7776
Entity
Organization
Contact information
Practice address
123 JOHNSTOWN DR, ROGERSVILLE, MO 65742-9366
(417) 753-7757
(417) 753-7757
Mailing address
123 JOHNSTOWN DR, ROGERSVILLE, MO 65742-9366
(417) 753-7757
(417) 753-7757
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
LC001451455
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
261665
MEDICARE PTAN
MO
01
—
581530
THE JOINT COMMISSION ACCREDITATION
MO
Enumeration date
07/25/2015
Last updated
06/20/2016
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