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NPI Code Detail

MEDICARE: GARDEN VIEW CARE CENTER OF ST. LOUIS, INC.

MEDICARE: GARDEN VIEW CARE CENTER OF ST. LOUIS, 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 Facility033296MO

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 : 1205996634
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARDEN VIEW CARE CENTER OF ST. LOUIS, INC.
Provider Business Mailing Address
First Line : 13612 BIG BEND RD
Second Line :
City : VALLEY PARK
State : MO
Zip : 63088-1447
Country : US
Telephone Number : 636-861-0500
Fax Number : 636-861-3414
Provider Business Practice Location Address
First Line : 13612 BIG BEND RD
Second Line :
City : VALLEY PARK
State : MO
Zip : 63088-1447
Country : US
Telephone Number : 636-861-0500
Fax Number : 636-861-3414
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. MICHAEL C. SCHRAPPEN
Credential : NHA
Telephone Number : 636-861-0500
Provider Enumeration Date : 12/08/2006
Last Update Date : 06/03/2008

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