BROOKSIDE MANOR RESIDENTIAL CARE LLC NPI 1275713638

NPI Information

  • NPI: 1275713638
  • Provider Name: BROOKSIDE MANOR RESIDENTIAL CARE, LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 2434 HIGHWAY H
    FARMINGTON, MO
    ZIP 63640
  • Phone: (573) 756-6434

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NPI Details

BROOKSIDE MANOR RESIDENTIAL CARE, LLC is an assisted living facility in Farmington, MO. The provider is 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. BROOKSIDE MANOR RESIDENTIAL CARE, LLC NPI is 1275713638. The provider is registered as an organization entity type.

The provider's business location address is:

2434 HIGHWAY H
FARMINGTON, MO
ZIP 63640-033
Phone: (573) 756-6434
Fax: (573) 756-6434

The provider's authorized official is Starla Kay Dulworth .
The authorized official title is Administrator/owner and has the following contact phone number (573) 756-6434.

The enumeration date for this NPI number is 11/13/2007 and was last updated on 11/13/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility034901MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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