Organization
LIFE ENHANCEMENT VILLAGE OF THE OZARKS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNY ROGERS (CEO)
(417) 725-6680
Entity
Organization
Contact information
Practice address
1111 CARE AVE, NIXA, MO 65714-9679
(417) 725-6680
Mailing address
1111 CARE AVE, NIXA, MO 65714
(417) 725-6680
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
034314
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3145500
—
MO
Enumeration date
12/27/2007
Last updated
12/27/2007
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