| NPI | 1730164583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GORDON CFO 314-729-3585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TN 102) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TN 102) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2021-05-11 |