Organization
MINGO RESIDENTIAL CARE OF PUXICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY R COLE (OWNER)
(573) 380-4113
Entity
Organization
Contact information
Practice address
24080 STATE HIGHWAY 51, PUXICO, MO 63960-8114
(573) 471-0466
(573) 471-4918
Mailing address
1515 E MALONE AVE, SIKESTON, MO 63801-3413
(573) 380-4413
(573) 471-4918
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/27/2020
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