Healthcare Provider Details

I. General information

NPI: 1336085182
Provider Name (Legal Business Name): CARL JUNCTION HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FIR RD
CARL JUNCTION MO
64834-9222
US

IV. Provider business mailing address

917 BROADWAY
HANNIBAL MO
63401-4200
US

V. Phone/Fax

Practice location:
  • Phone: 417-782-5659
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA WILLIAMS
Title or Position: MANAGER
Credential:
Phone: 573-795-5012