National Provider Identifier Database

VICTORIAN MANOR OF SULLIVAN
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.


Contact Information

VICTORIAN MANOR OF SULLIVAN
1250 EAST SPRINGFIELD RD
SULLIVAN, MO63080
Phone: 573-437-2103
Fax: 573-437-2219
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X

* Indicates primary specialty

NPI Profile & details for VICTORIAN MANOR OF SULLIVAN

NPI Number 1407099500
Legal business name
LBN
VICTORIAN MANOR OF SULLIVAN
Authorized official NANCY QUICK - (SECRETARY)
Entity Organization
Organization subpart No
Enumeration date 04/20/2009
Last updated 04/20/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: 26324D

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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