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NPI Code Detail

MEDICARE: LADELLE INVESTMENT CO., INC.

MEDICARE: LADELLE INVESTMENT CO., INC.
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 Facility028885MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194722439
Entity Type Code : Organization
Provider Name (Legal Business Name) : LADELLE INVESTMENT CO., INC.
Provider Business Mailing Address
First Line : 473 N KIRKWOOD RD
Second Line :
City : KIRKWOOD
State : MO
Zip : 63122-3911
Country : US
Telephone Number : 314-821-7007
Fax Number : 314-821-7012
Provider Business Practice Location Address
First Line : 936 CHARBONIER RD
Second Line :
City : FLORISSANT
State : MO
Zip : 63031-5220
Country : US
Telephone Number : 314-831-4800
Fax Number : 314-831-1310
Authorized Official
Title or Position : CORPORATE SECRETARY
Name : MR. DENNIS G MENOS
Credential :
Telephone Number : 314-821-7007
Provider Enumeration Date : 07/01/2005
Last Update Date : 03/24/2014

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Directions to “LADELLE INVESTMENT CO., INC. ” Practice Location

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