Organization
BROOKSIDE MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE NICHOLSON RN (OWNER OPERATOR)
(573) 756-6434
Entity
Organization
Contact information
Practice address
2434 HIGHWAY H, FARMINGTON, MO 63640-7033
(573) 756-6434
(573) 756-6434
Mailing address
2434 HIGHWAY H, FARMINGTON, MO 63640-7033
(573) 756-6434
(573) 756-6434
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
033659
MO
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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