Organization
FIVE STAR QUALITY CARE MO LLC
Active
Parent organization
FIVE STAR QUALITY CARE MO LLC
Other names
Northview Manor
Organization subpart
Yes
Provider details
NPI number
Legal business name
FIVE STAR QUALITY CARE MO LLC
Authorized official
BRUCE J MACKEY JR. (CEO)
(617) 796-8387
Entity
Organization
Contact information
Practice address
300 CEDAR ST, TARKIO, MO 64491-1174
(660) 736-4116
(660) 736-5545
Mailing address
400 CENTRE ST, NEWTON, MA 02458-2094
(617) 796-8387
(617) 796-8375
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
032430
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101480200
—
MO
Enumeration date
05/24/2006
Last updated
05/29/2008
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