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General NPI Number Information
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NPI Number | 1003933607
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Entity Type | Organization
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Legal Business Name | MCKNIGHT PLACE EXTENDED CARE LLC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2 MCKNIGHT PL
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City | SAINT LOUIS
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State | MO
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Zip | 63124-1900
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Country | US
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Telephone | 314-993-2221
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Fax | 314-372-2300
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Provider Business Mailing Address
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Address Line | 2 MCKNIGHT PL
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City | SAINT LOUIS
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State | MO
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Zip | 63124-1900
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Country | US
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Telephone | 314-993-2221
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Fax | 314-372-2300
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. GLENDA KNITTEL
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Credential | LNHA
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Telephone | 314-993-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 033219
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License Number State | MO
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