| NPI | 1477544104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE CHAMPION Officer 314-842-6840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 030733) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: MO 030527) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2020-09-29 |