Organization
LIVINGSTON MANOR INC
Active
Other names
Livingston Manor Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAL JUCKETTE (OWNER)
(660) 646-5177
Entity
Organization
Contact information
Practice address
939 E BIRCH DR, CHILLICOTHE, MO 64601-2189
(660) 646-5177
(660) 646-5186
Mailing address
939 E BIRCH DR, CHILLICOTHE, MO 64601-2189
(660) 646-5177
(660) 646-5186
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
017795
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102201902
—
MO
Enumeration date
09/13/2006
Last updated
07/05/2012
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