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General NPI Number Information
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NPI Number | 1366570079
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Entity Type | Organization
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Legal Business Name | ST. JOHNS PLACE, INC.
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3333 BROWN RD
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City | SAINT LOUIS
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State | MO
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Zip | 63114-4327
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Country | US
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Telephone | 314-426-2211
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Fax | 314-890-2280
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Provider Business Mailing Address
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Address Line | 3333 BROWN RD
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City | SAINT LOUIS
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State | MO
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Zip | 63114-4327
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Country | US
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Telephone | 314-426-2211
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Fax | 314-890-2280
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Authorized Official
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Title or Position | ADMINISTRATOR OWNER
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Name | MR. DAVID J BENTLEY
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Credential |
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Telephone | 314-426-2211
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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 | 033727
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License Number State | MO
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