Organization
PACIFIC CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRETCHEN R ROBERTS-HOAGLIN R.N. LICENSED NURSIN (ADMINISTRATOR)
(636) 271-4222
Entity
Organization
Contact information
Practice address
105 SOUTH SIXTH STREET, PACIFIC, MO 63069
(636) 271-4222
(636) 257-8002
Mailing address
105 SOUTH SIXTH STREET, PACIFIC, MO 63069
(636) 271-4222
(636) 257-8002
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
036467
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102343001
—
MO
Enumeration date
03/25/2009
Last updated
10/24/2012
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