Lake Stockton Healthcare Facility

LBN: Citizens Memorial Health Care Foundation
Lake Stockton Healthcare Facility is an health care organization with primary practice located at 811 Owens Mill Rd , Stockton MO 65785. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Citizens Memorial Health Care Foundation can be contacted via phone (417) 276-5126, or through Costello, Kevin via phone (417) 276-5126.

Contact Information

Primary practice address
811 Owens Mill Rd Stockton MO 65785
Phone: (417) 276-5126
Fax: (417) 276-8376
Website:
Map and Directions
Authorized official contact:
Name: Costello, Kevin
Phone: (417) 276-5126

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 039681 Missouri

Profile Details

NPI number 1134109713
LBN Legal business name Citizens Memorial Health Care Foundation
DBA Doing business as Lake Stockton Healthcare Facility
Authorized official Costello, Kevin
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2006
Last updated Dec 11th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134109713 NPPES
Missouri MEDICAID 101496305

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