Organization
ELLINGTON 1 INC
Active
Other names
Brent B Tinnin Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
220 EUEL POLK DR, ELLINGTON, MO 63638-7967
(573) 663-2545
Mailing address
PO BOX 1210, SIKESTON, MO 63801-1210
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
045515
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101776201
—
MO
Enumeration date
07/07/2006
Last updated
08/30/2017
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