Healthcare Provider Details

I. General information

NPI: 1801116207
Provider Name (Legal Business Name): WEST COUNTY REGIONAL REHAB CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13190 S OUTER 40 RD
CHESTERFIELD MO
63017-5917
US

IV. Provider business mailing address

13190 S OUTER 40 RD
CHESTERFIELD MO
63017-5917
US

V. Phone/Fax

Practice location:
  • Phone: 314-434-3330
  • Fax: 314-434-9179
Mailing address:
  • Phone: 314-434-3330
  • Fax: 314-434-9179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MARYA MORRISON
Title or Position: CFO
Credential:
Phone: 727-723-3000