Frederick Street Manor LLC
NPI #1518535285 in Cape Girardeau, Missouri
Provider Information
- NPI Number
- 1518535285
- Entity Type
- Organization
- Organization Name
- Frederick Street Manor LLC
- Primary Specialty
- Assisted Living Facility - Assisted Living, Mental Illness
- Enumeration Date
- Jun 17, 2021
- Last Updated
- Jun 17, 2021
Practice Location
- Address
- 429 N FREDERICK ST
- City
- Cape Girardeau
- State
- Missouri
- ZIP Code
- 63701-4834
- Phone
- (573) 334-0916
Authorized Official
- Name
- KEVIN WOOD
- Title
- OWNER
- Phone
- (573) 576-3029
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
| Assisted Living Facility - Assisted Living, Mental Illness — Assisted Living, Mental Illness |
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