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NPI Code Detail

MEDICARE: FRIENDSHIP VILLAGE OF WEST COUNTY

MEDICARE: FRIENDSHIP VILLAGE OF WEST COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility031648MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2031648OTHERMOSTATE LICENSE

General Provider Information

NPI Number : 1386635910
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRIENDSHIP VILLAGE OF WEST COUNTY
Provider Business Mailing Address
First Line : 15250 VILLAGE VIEW DRIVE
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63017-1810
Country : US
Telephone Number : 636-532-1515
Fax Number : 636-733-0139
Provider Business Practice Location Address
First Line : 15250 VILLAGE VIEW DRIVE
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63017-1810
Country : US
Telephone Number : 636-532-1515
Fax Number : 636-733-0139
Authorized Official
Title or Position : OFFICER
Name : SUE CHAMPION
Credential :
Telephone Number : 314-270-7810
Provider Enumeration Date : 11/02/2005
Last Update Date : 10/01/2020

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Directions to “FRIENDSHIP VILLAGE OF WEST COUNTY ” Practice Location

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