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General NPI Number Information
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NPI Number | 1467321752
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Entity Type | Organization
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Legal Business Name | RICHMOND HEIGHTS CCRC LLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 562 RICHMOND RD
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City | CLEVELAND
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State | OH
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Zip | 44143-2906
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Country | US
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Telephone | 216-291-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 1869 CRAIG PARK CT
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City | SAINT LOUIS
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State | MO
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Zip | 63146-4122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NICHOLAS DESTEFANE
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Credential |
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Telephone | 314-543-3800
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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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