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General NPI Number Information
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NPI Number | 1336311729
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Entity Type | Organization
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Legal Business Name | TWIN OAKS ESTATE, INC
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 03/26/2008
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Provider Practice Location Address
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Address Line | 707 EMGE RD
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City | O FALLON
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State | MO
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Zip | 63366-2118
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Country | US
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Telephone | 636-240-6152
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Fax |
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Provider Business Mailing Address
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Address Line | 707 EMGE RD
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City | O FALLON
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State | MO
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Zip | 63366-2118
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Country | US
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Telephone | 636-240-6152
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Fax |
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Authorized Official
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Title or Position | PAYROLL MANAGER / OWNER
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Name | KIM BAUER
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Credential |
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Telephone | 636-240-6152
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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 | 034141
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License Number State | MO
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