| NPI | 1376433342 |
|---|---|
| Doing Business As | HIDDEN LAKE HEALTH CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | RICHARD J. DESTEFANE President 314-543-3805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) |
| Enumeration Date | 2025-07-09 |
| Last Update Date | 2025-10-02 |