Wagner Residential Care INC
NPI #1154673887 in Fredericktown, Missouri
Provider Information
- NPI Number
- 1154673887
- Entity Type
- Organization
- Organization Name
- Wagner Residential Care INC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Oct 4, 2012
- Last Updated
- Apr 4, 2016
Practice Location
- Address
- 320 N CHAMBER DR
- City
- Fredericktown
- State
- Missouri
- ZIP Code
- 63645-0320
- Phone
- (573) 783-4511
Authorized Official
- Name
- TEENA WAGNER
- Title
- OWNER/MANAGER
- Phone
- (573) 783-4511
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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