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General NPI Number Information
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NPI Number | 1205865953
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Entity Type | Organization
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Legal Business Name | BOONE COUNTY SENIOR CITIZEN SERVICE CORPORATION
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 3105 BLUFF CREEK DRIVE
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City | COLUMBIA
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State | MO
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Zip | 65201-3529
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Country | US
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Telephone | 573-442-6060
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Fax | 573-875-8060
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Provider Business Mailing Address
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Address Line | 3105 BLUFF CREEK DR
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City | COLUMBIA
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State | MO
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Zip | 65201-3529
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Country | US
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Telephone | 573-442-6060
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Fax | 573-874-8060
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | MRS. ASHA SHAON
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Credential |
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Telephone | 573-442-6060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 032158
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License Number State | MO
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