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Organization

LAKESIDE MOUNTAIN MANOR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBRA JEAN DROLL (MEMBER)
(417) 546-5595
Entity
Organization

Contact information

Practice address
238 HARMONY HTS, FORSYTH, MO 65653-5533
(417) 546-5595
(417) 546-2829
Mailing address
238 HARMONY HTS, FORSYTH, MO 65653-5533
(417) 546-5595
(417) 546-2829

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
034594
MO

Other

Enumeration date
08/15/2007
Last updated
08/15/2007
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