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NPI Code Detail

MEDICARE: LANSDOWNE HEALTHCARE, LLC

MEDICARE: LANSDOWNE HEALTHCARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1184231748
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANSDOWNE HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 477 N LINDBERGH BLVD STE 310
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63141-7856
Country : US
Telephone Number : 314-631-3000
Fax Number :
Provider Business Practice Location Address
First Line : 4624 LANSDOWNE AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63116-1523
Country : US
Telephone Number : 314-631-3000
Fax Number :
Authorized Official
Title or Position : CEO
Name : JUDAH BIENSTOCK
Credential :
Telephone Number : 314-631-3000
Provider Enumeration Date : 09/28/2020
Last Update Date : 09/28/2020

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