Organization
DESOTO INVESTMENT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BROOKE MICHELLE BIGHAM (PRESIDENT)
(417) 425-3062
Entity
Organization
Contact information
Practice address
3260 BAISCH DR, DE SOTO, MO 63020-5046
(417) 425-3062
Mailing address
375 FONTANA LN, LINN CREEK, MO 65052-2584
(417) 425-3062
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266906304
RCF PROVIDER NUMBER
MO
Enumeration date
09/13/2016
Last updated
09/13/2016
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