| NPI | 1083857650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE ELAINE MOORE Rehab Tech. 314-771-2990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-04-13 |