Healthcare Provider Details

I. General information

NPI: 1528992278
Provider Name (Legal Business Name): MEADOWLARK GARDENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 MEADOWLARK AVE
CRANE MO
65633-9317
US

IV. Provider business mailing address

509 MEADOWLARK AVE
CRANE MO
65633-9317
US

V. Phone/Fax

Practice location:
  • Phone: 417-402-3814
  • 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: AMY MARIE MOISON
Title or Position: LLC MANAGING MEMBER
Credential:
Phone: 417-402-3814