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CRESTWOOD HEALTH CARE CENTER L.L.C. NPI 1083882682


NPI Information

NPI: 1083882682
Provider Name: CRESTWOOD HEALTH CARE CENTER, L.L.C.

Doing Business As: CRESTWOOD HEALTH CARE CENTER

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 26D0891295

Address:
11400 MEHL AVENUE
FLORISSANT, MO
ZIP 63033
Phone: (314) 741-3525
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CRESTWOOD HEALTH CARE CENTER, L.L.C. is a nursing facility intermediate care facility in Florissant, MO. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. CRESTWOOD HEALTH CARE CENTER, L.L.C. NPI is 1083882682. The provider is registered as an organization entity type.
The provider Is Doing Business As Crestwood Health Care Center.

The provider's business location address is:

11400 MEHL AVENUE
FLORISSANT, MO
ZIP 63033-204
Phone: (314) 741-3525
Fax: (314) 741-3721

The provider's authorized official is Ashwin Dundoo .
The authorized official title is Finance and has the following contact phone number (314) 543-3800.

The CLIA number assigned to this NPI record is 26D0891295 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2008 and was last updated on 4/4/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1313M00000XNursing Facility/Intermediate Care FacilityNo
2313M00000XNursing Facility/Intermediate Care Facility038173MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1102504701MEDICAIDMISSOURI
2265823MEDICARE OSCAR/CERTIFICATIONMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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