NPI 1407099500

Victorian Manor of Sullivan

Organisation Assisted Living Facility Sullivan, MO

Practice location

Address: 1250 East Springfield Rd, Sullivan, MO 63080
Phone: (573) 437-2103
Fax: (573) 437-2219
Mailing address: 1015 Springfield Rd, Owensville, MO 65066

Authorised official

Name: Nancy Quick
Title: Secretary
Phone: (573) 437-2103

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 26324D (MO)

Other Assisted Living Facility providers in Missouri →

Registry record

NPI: 1407099500
Entity type: Organization
NPI issued: 20 Apr 2009
Record last updated: 20 Apr 2009

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.