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General NPI Number Information
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NPI Number | 1841916764
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Entity Type | Organization
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Legal Business Name | ANNIE'S HOUSE, INC.
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 25228 BUZZARD DR
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City | MARBLE HILL
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State | MO
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Zip | 63764-7481
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Country | US
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Telephone | 573-238-1300
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Fax | 573-238-1302
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Provider Business Mailing Address
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Address Line | 25228 BUZZARD DR
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City | MARBLE HILL
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State | MO
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Zip | 63764-7481
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Country | US
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Telephone | 573-979-6053
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Fax | 573-238-1302
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | ANDREA DANIELLE COOK
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Credential |
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Telephone | 573-979-6053
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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 |
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