Organization
L & J RESIDENTIAL, LLC
Active
Other names
L & J Residential Care
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L NOLTING (MANAGER)
(573) 756-3047
Entity
Organization
Contact information
Practice address
4985 HIGHWAY D, FARMINGTON, MO 63640-7244
(537) 759-6304
Mailing address
PO BOX 251, SAINT PETERS, MO 63376-0005
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
031382
MO
Other
Enumeration date
03/31/2007
Last updated
08/22/2020
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