Organization
LEWIS COUNTY NURSING HOME DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY ANN PEARL (ADMINISTRATOR)
(573) 288-4454
Entity
Organization
Contact information
Practice address
17528 STATE HIGHWAY 81, CANTON, MO 63435-3463
(573) 288-4454
(573) 288-5735
Mailing address
PO BOX 266, 17528 HWY 81 N, CANTON, MO 63435-0266
(573) 288-4454
(573) 288-5735
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031316
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101489508
—
MO
Enumeration date
09/02/2005
Last updated
01/12/2010
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