Organization
LACOBA HOMES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D BALDUS (ADMINISTRATOR)
(417) 235-7895
Entity
Organization
Contact information
Practice address
850 HWY 60 E, MONETT, MO 65708-9376
(417) 235-7895
(417) 235-0093
Mailing address
PO BOX 885, MONETT, MO 65708-0885
(417) 235-7895
(417) 235-0093
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102935707
—
MO
Enumeration date
08/09/2005
Last updated
07/21/2022
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