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General NPI Number Information
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NPI Number | 1073678165
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Entity Type | Organization
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Legal Business Name | SAINT CLARES VILLA LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 915 E 5TH ST
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City | ALTON
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State | IL
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Zip | 62002-6434
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Country | US
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Telephone | 618-463-9000
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Fax | 618-463-0995
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Provider Business Mailing Address
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Address Line | PO BOX 340
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City | ALTON
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State | IL
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Zip | 62002-0340
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Country | US
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Telephone | 618-463-9000
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Fax | 618-463-0995
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. MARK WEBER
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Credential |
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Telephone | 618-465-2571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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