Organization
AMBROSE PARK RESIDENTIAL CARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REXANNA KAY KREISEL R.N. (OWNER)
(660) 668-3140
Entity
Organization
Contact information
Practice address
517 NORTH OAK STREET, COLE CAMP, MO 65325
(660) 668-3140
(660) 668-0108
Mailing address
PO BOX 252, COLE CAMP, MO 65325-0252
(660) 668-3140
(660) 668-0108
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
037166
MO
Other
Enumeration date
07/27/2009
Last updated
07/30/2009
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