Organization
MEDICALODGES, INC.
Active
Other names
Gran Villas Clinton
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY W FISHER (CHIEF FINANCIAL OFFICER)
(620) 251-6700
Entity
Organization
Contact information
Practice address
509 W ROGERS ST, CLINTON, MO 64735-2548
(660) 885-9770
(660) 885-9844
Mailing address
509 W ROGERS ST, CLINTON, MO 64735-2548
(660) 885-9770
(660) 885-9844
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
032347
MO
261QA0600X
Adult Day Care Clinic/Center
Primary
032347
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032347
—
MO
Enumeration date
10/18/2006
Last updated
06/23/2008
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