Healthcare Provider Details

I. General information

NPI: 1720012347
Provider Name (Legal Business Name): ST. ANDREW'S AT FRANCIS PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FORBY ROAD
EUREKA MO
63025-0476
US

IV. Provider business mailing address

300 FORBY ROAD
EUREKA MO
63025-0476
US

V. Phone/Fax

Practice location:
  • Phone: 636-938-5151
  • Fax: 636-938-5266
Mailing address:
  • Phone: 636-938-5151
  • Fax: 636-938-5266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number031926
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number041491
License Number StateMO

VIII. Authorized Official

Name: MARY A. RYAN
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 314-726-2773