Healthcare Provider Details

I. General information

NPI: 1881729432
Provider Name (Legal Business Name): MOUNT CARMEL COMMUNITIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 1ST CAPITOL DR
SAINT CHARLES MO
63301-2729
US

IV. Provider business mailing address

723 1ST CAPITOL DR
SAINT CHARLES MO
63301-2729
US

V. Phone/Fax

Practice location:
  • Phone: 636-946-4140
  • Fax: 636-946-1104
Mailing address:
  • Phone: 636-946-4140
  • Fax: 636-946-1104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number033416
License Number StateMO

VIII. Authorized Official

Name: C CHRISTOPHER BROWN
Title or Position: EXECUTIVE DIRECTOR/COO
Credential:
Phone: 636-946-4140