Organization
FOUR SEASONS LIVING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JOSEPH DESTEFANE (PRESIDENT)
(314) 543-3800
Entity
Organization
Contact information
Practice address
2800 HIGHWAY TT, SEDALIA, MO 65301-1410
(660) 826-8803
(660) 826-6864
Mailing address
2800 HIGHWAY TT, SEDALIA, MO 65301-1410
(660) 826-8803
(660) 826-6864
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
08/22/2020
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