CRESTWOOD HEALTH CARE CENTER, L.L.C. (NPI# 1083882682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083882682 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD HEALTH CARE CENTER, L.L.C. |
| Other Organization Name | CRESTWOOD HEALTH CARE CENTER |
| Practice Address |
11400 Mehl Avenue Florissant MO 63033-7204 |
| Mailing Address |
1869 Craig Park Ct Saint Louis MO 63146-4122 |
| Practice Telephone | 3147413525 |
| Practice Fax Number | 3147413721 |
| Mailing Telephone | 3145433800 |
| Mailing Fax Number | 3145433880 |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2013-04-04 |
| Authorized Official Name | MR. ASHWIN DUNDOO (FINANCE) |
| Authorized Official Telephone | 3145433800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities | ||
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 038173 | MO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 102504701 | 05 |
| Other Name | Type Code |
|---|---|
| Crestwood Health Care Center | Doing Business As Name - Organization |
| Street Address |
11400 MEHL AVENUE |
| City | FLORISSANT |
| State | MO |
| Zip Code | 63033-7204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376191841 | Victoria Crews | Technician | 13114 Tree's Edge Ct, Black Jack, MO 63033 | 2019-08-28 |
| 1275195976 | Herbal Envy Spa LLC | Home Health Aide | 12630 Shoreside Drive, Florissant, MO 63033 | 2019-07-02 |
| 1689231169 | Patrice Edora Hall | Clinic/Center | 500 Greenway Manor, Florissant, MO 63033 | 2019-05-21 |
| 1689153082 | Sew St. Louis LLC | Specialist | 2172 N Waterford Dr, Florissant, MO 63033 | 2018-08-07 |
| 1508344706 | Rekendra Farmer | Home Health | 3070 Kingsley Dr, Florissant, MO 63033 | 2018-07-31 |
| 1033616594 | B & J Consumer Directed Services | Home Health | 5 Farm Country Ct, Florissant, MO 63033 | 2018-04-11 |
| 1245740265 | Trusting Hands Home Health Services LLC | Home Health | 2430 Dresden Dr, Florissant, MO 63033 | 2017-10-04 |
| 1194243477 | Betty Moore | Registered Nurse | 2875 Devonshire Dr, Florissant, MO 63033 | 2017-09-06 |
| 1467976118 | Imperial Home Care, LLC | Home Health | 11674 Arroyo Dr, Florissant, MO 63033 | 2017-08-02 |
| 1194248492 | Apex Home Health Care Services LLC | Home Health | 3145 Kingsley Dr, Florissant, MO 63033 | 2017-07-19 |
| Find all providers in zip 63033 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| 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. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417334137 | Holistic Healthcare LLC | Nursing Facility/Intermediate Care Facility | 4630 Robbins Grove Dr, Florissant, MO 63034-2840 | 2015-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316488075 | Anna's House Residential Care Facility LLC | Nursing Facility/Intermediate Care Facility | 194 State Highway Mm, Niangua, MO 65713-8411 | 2017-03-14 |
| 1841667565 | Univest, LLC | Nursing Facility/Intermediate Care Facility | 1401 W 3rd St, Sedalia, MO 65301-3603 | 2015-08-28 |
| 1295123420 | Erin Eggen | Nursing Facility/Intermediate Care Facility | 1101 Clay Street, Versailles, MO 65084 | 2014-12-22 |
| 1518303296 | Leaetta Mildred Gardner | Nursing Facility/Intermediate Care Facility | 13450 County Road 7040, Rolla, MO 65401 | 2013-05-21 |
| 1376893297 | Reliant Care Rehabilitative Services | Nursing Facility/Intermediate Care Facility | 411 Robert Ave, Ferguson, MO 63135-3526 | 2012-09-18 |
| 1487975363 | Neighborhood Outreach Center | Nursing Facility/Intermediate Care Facility | 5325 Dr Martin Luther King Dr, Saint Louis, MO 63112-4256 | 2010-06-15 |
| 1205168523 | Nirmal K Samanta | Nursing Facility/Intermediate Care Facility | 250 Brandy Ln, Cape Girardeau, MO 63701-8443 | 2010-02-11 |
| 1225228455 | St Josephs Hill Infirmary Inc | Nursing Facility/Intermediate Care Facility | 265 St Joseph Road, Eureka, MO 63025-0550 | 2007-07-25 |
| 1316148026 | Jones Wildwood Care Center | Nursing Facility/Intermediate Care Facility | 12806 Highway 151, Madison, MO 65263-3114 | 2007-05-30 |
| 1396959045 | Blue Ridge Nursing Home | Nursing Facility/Intermediate Care Facility | 7505 E 87th St, Kansas City, MO 64138-3917 | 2007-05-10 |
| Find all providers with the same taxonomy | ||||
| City | FLORISSANT |
| Zip Code | 63033 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.