Organization
VICTORIAN MANOR OF ST CLAIR
Active
Other names
Victorian Manor of St Clair
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY L QUICK (SECRETARY)
(573) 437-2103
Entity
Organization
Contact information
Practice address
160 CHARLES DR, ST CLAIR, MO 63077
(636) 322-0003
(636) 322-0006
Mailing address
1015 SPRINGFIELD RD, OWENSVILLE, MO 65066-1015
(573) 437-2103
(573) 437-2219
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
036029
MO
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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