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General NPI Number Information
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NPI Number | 1487044293
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Entity Type | Organization
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Legal Business Name | NEELUM LLC
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Dates
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Enumeration Date | 02/01/2015
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Last Update Date | 02/01/2015
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Provider Practice Location Address
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Address Line | 3610 PALM ST
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City | SAINT LOUIS
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State | MO
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Zip | 63107-2206
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Country | US
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Telephone | 314-533-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 13210 CLAYTON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-1001
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Country | US
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Telephone | 314-533-3111
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Fax |
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Authorized Official
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Title or Position | MEMBER LLC
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Name | ALI CHAUDHRY
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Credential |
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Telephone | 314-533-3111
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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 | 042872
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License Number State | MO
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