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General NPI Number Information
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NPI Number | 1235117532
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Entity Type | Organization
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Legal Business Name | RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED CHILDREN
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 11365 DORSETT RD
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3411
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Country | US
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Telephone | 314-872-6400
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Fax | 314-872-6500
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Provider Business Mailing Address
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Address Line | 11365 DORSETT RD
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3411
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Country | US
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Telephone | 314-872-6400
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Fax | 314-872-6500
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Authorized Official
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Title or Position | CEO
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Name | MR. SHAWN DRYDEN
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Credential |
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Telephone | 314-872-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 472-3
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License Number State | MO
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