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General NPI Number Information
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NPI Number | 1487715793
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Entity Type | Organization
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Legal Business Name | THE WOODLANDS OF MARYLAND HEIGHTS LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 3201 PARKWOOD LN
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-1334
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Country | US
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Telephone | 314-291-5911
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Fax | 314-291-3576
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Provider Business Mailing Address
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Address Line | 1749 GILSINN LN
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City | FENTON
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State | MO
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Zip | 63026-2003
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Country | US
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Telephone | 636-349-2311
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Fax | 636-349-6491
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Authorized Official
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Title or Position | MEMEBER
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Name | MR. CHARLES J RILEY
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Credential |
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Telephone | 636-349-2311
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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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