Healthcare Provider Details
I. General information
NPI: 1851227334
Provider Name (Legal Business Name): EASTVIEW SNF OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1622 E 28TH ST
TRENTON MO
64683-1104
US
IV. Provider business mailing address
1869 CRAIG PARK CT
SAINT LOUIS MO
63146-4122
US
V. Phone/Fax
- Phone: 660-359-2251
- Fax: 660-359-6667
- Phone: 314-543-3800
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLAS
DESTEFANE
Title or Position: PRESIDENT
Credential:
Phone: 314-543-3800