NPI 1811929623

Olive Mountain Residential Care LLC

Organisation Assisted Living Facility Lebanon, MO

Practice location

Address: 25466 N Hwy 5, Lebanon, MO 65536-0969
Phone: (417) 532-3045
Fax: (417) 532-4104
Mailing address: PO Box 969, Lebanon, MO 65536-0969

Authorised official

Name: Stephanie Nichole Upton
Title: Financial Manager
Phone: (417) 532-3045

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 033209 (MO)

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Registry record

NPI: 1811929623
Entity type: Organization
NPI issued: 6 Jul 2006
Record last updated: 22 Aug 2020

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.