Provider Demographics
NPI:1750955209
Name:MKALMA, LLC
Entity type:Organization
Organization Name:MKALMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DI DI
Authorized Official - Middle Name:
Authorized Official - Last Name:TERBRAK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:573-768-5155
Mailing Address - Street 1:1019 OLD SAINT MARYS RD
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1298
Mailing Address - Country:US
Mailing Address - Phone:573-768-5155
Mailing Address - Fax:573-547-6246
Practice Address - Street 1:1019 OLD SAINT MARYS RD
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-1298
Practice Address - Country:US
Practice Address - Phone:573-768-5155
Practice Address - Fax:573-547-6246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility