Organization
GASCONADE MANOR NURSING HOME DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL LYNN RAY ADMINISTRATOR (ADMINISTRATOR)
(573) 437-4101
Entity
Organization
Contact information
Practice address
1910 NURSING HOME ROAD, OWENSVILLE, MO 65066-2844
(573) 437-4101
(573) 437-3925
Mailing address
PO BOX 520, 1910 NURSING HOME ROAD, OWENSVILLE, MO 65066-0520
(573) 437-4101
(573) 437-3925
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031054
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101486702
—
MO
Enumeration date
01/29/2007
Last updated
09/12/2014
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