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General NPI Number Information
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NPI Number | 1013427780
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Entity Type | Organization
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Legal Business Name | STEELVILLE SENIOR LIVING, LLC
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Dates
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Enumeration Date | 10/06/2017
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Last Update Date | 10/06/2017
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Provider Practice Location Address
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Address Line | 311 N SPRING ST
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City | STEELVILLE
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State | MO
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Zip | 65565-5089
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Country | US
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Telephone | 573-556-6240
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Fax | 573-556-6241
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Provider Business Mailing Address
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Address Line | 3225 EMERALD LN STE B
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-6869
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Country | US
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Telephone | 573-556-6240
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Fax | 573-556-6241
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | CYNTHIA R JUCKETTE
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Credential |
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Telephone | 660-214-0051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | MO
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