Organization
WILLOWS LAKEVIEW VILLAGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN M SELLS (PRESIDENT)
(636) 536-5365
Entity
Organization
Contact information
Practice address
220 COLLEGE ST, PURYEAR, TN 38251-6441
(731) 247-3205
(731) 247-5205
Mailing address
17826 EDISON AVE, CHESTERFIELD, MO 63005-1262
(636) 536-5365
(636) 536-4533
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/20/2009
Last updated
11/08/2013
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