| NPI | 1205023967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDRA SAVIC Director 314-994-9070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IL 1854224) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2017-01-31 |