Healthcare Provider Details

I. General information

NPI: 1982633053
Provider Name (Legal Business Name): LUTHERAN SENIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MERAMEC TRAIL DR
BALLWIN MO
63021-3303
US

IV. Provider business mailing address

1150 HANLEY INDUSTRIAL CT
SAINT LOUIS MO
63144-1910
US

V. Phone/Fax

Practice location:
  • Phone: 636-861-0600
  • Fax: 636-861-1960
Mailing address:
  • Phone: 314-968-9313
  • Fax: 314-968-5590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number040591
License Number StateMO

VIII. Authorized Official

Name: CHADWICK SNEED
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 314-446-2405