Organization
STELLBROOK MANAGEMENT, LLC
Active
Other names
Walnut Street Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB HOGG (ADMINISTRATOR)
(573) 712-2992
Entity
Organization
Contact information
Practice address
404 WALNUT ST, DONIPHAN, MO 63935-1420
(573) 712-2992
Mailing address
1321 W MAUD ST, POPLAR BLUFF, MO 63901-4819
(573) 712-2992
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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