NPI 1326113077

Country Aire Estates LLC

Organisation Assisted Living Facility (Mental Illness) Hannibal, MO

Practice location

Address: 49303 Rensselaer Ln, Hannibal, MO 63401-7356
Phone: (573) 221-5400
Fax: (573) 221-5437

Authorised official

Name: Georgia May Noland
Title: Owner
Phone: (573) 221-5400

Registered specialties

Assisted Living Facility (Mental Illness) Primary

Nursing & Custodial Care Facilities Taxonomy 3104A0625X Licence 018850 (MO)

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Registry record

NPI: 1326113077
Entity type: Organization
NPI issued: 21 Nov 2006
Record last updated: 3 Feb 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.