Organization
FULTON MANOR INC
Active
Other names
Fulton Manor Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAL JUCKETTE (DIRECTOR OF OPERATIONS)
(660) 646-5385
Entity
Organization
Contact information
Practice address
520 MANOR DR, FULTON, MO 65251-2429
(573) 642-6834
(573) 642-5767
Mailing address
520 MANOR DR, FULTON, MO 65251-2429
(573) 642-6834
(573) 642-5767
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
015923
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107871204
—
MO
Enumeration date
09/13/2006
Last updated
07/16/2012
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