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General NPI Number Information
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NPI Number | 1285908426
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Entity Type | Organization
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Legal Business Name | THE CEDARS OF TOWN AND COUNTRY, LLC
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 13190 S OUTER 40 RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5917
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Country | US
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Telephone | 314-434-3330
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Fax | 314-434-9179
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Provider Business Mailing Address
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Address Line | 13190 S OUTER 40 RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5917
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Country | US
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Telephone | 314-434-3330
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Fax | 314-434-9179
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Authorized Official
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Title or Position | MEMBER/MANAGER OF LLC
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Name | MAKHLOUF SUISSA
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Credential |
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Telephone | 917-744-8688
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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 |
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License Number State |
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