| NPI | 1376893297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY SUSAN PERNELL L PT A 314-524-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MO 116138) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |