| NPI | 1801028956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE RENEE GANTNER Program Manager 636-379-9106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MO 1999137004) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |