Organization
CARONDELET LONG TERM CARE FACILITIES, INC.
Active
Other names
St. Mary's Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY COLUMBATTO (ADMINISTRATOR, CEO)
(816) 228-5655
Entity
Organization
Contact information
Practice address
111 NW MOCK AVE, BLUE SPRINGS, MO 64014-2503
(816) 228-5655
(816) 228-8480
Mailing address
111 NW MOCK AVE, BLUE SPRINGS, MO 64014-2503
(816) 228-5655
(816) 228-8480
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031289
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102390309
—
MO
Enumeration date
08/16/2005
Last updated
10/27/2014
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