Organization
AVA NO 2 INC
Active
Other names
AVA PLACE
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
1011 LYLE STREET, AVA, MO 65608-5588
(417) 683-5516
Mailing address
731 N MAIN ST, PO BOX 1210, SIKESTON, MO 63801-2151
(573) 471-1276
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
045057
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268207800
—
MO
Enumeration date
03/13/2012
Last updated
07/21/2022
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