VICTORIAN MANOR OF ST CLAIR (NPI# 1568614063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568614063 |
| Entity Type | Organization |
| Organization Name | VICTORIAN MANOR OF ST CLAIR |
| Other Organization Name | VICTORIAN MANOR OF ST CLAIR |
| Practice Address |
160 Charles Dr St Clair MO 63077 |
| Mailing Address |
1015 Springfield Rd Owensville MO 65066-1015 |
| Practice Telephone | 6363220003 |
| Practice Fax Number | 6363220006 |
| Mailing Telephone | 5734372103 |
| Mailing Fax Number | 5734372219 |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2008-10-15 |
| Authorized Official Name | NANCY L QUICK (SECRETARY) |
| Authorized Official Telephone | 5734372103 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 036029 | MO | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Victorian Manor of St Clair | Other Name - Individual/Organization |
| Street Address |
160 CHARLES DR |
| City | ST CLAIR |
| State | MO |
| Zip Code | 63077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346687845 | Medley Pharmacy Inc. | Durable Medical Equipment & Medical Supplies | 1435 N. Main St., St. Clair, MO 63077 | 2013-05-24 |
| 1225367337 | St Clair Allergy-asthma | Specialist | 1020 St. Clair Plaza, St. Clair, MO 63077 | 2009-12-18 |
| 1962664052 | Anita Farris Altemeyer | Physical Therapist | 214 Hartman Place, St Clair, MO 63077 | 2008-06-30 |
| 1184845729 | James Leroy Bunge | Dentist | 525 E Springfield Rd, St. Clair, MO 63077 | 2007-05-01 |
| 1720113053 | John D Marcum | Allergy & Immunology | 1020 St Clair Plaza, St Clair, MO 63077 | 2007-02-23 |
| 1538227970 | St. Clair Ambulance District | Ambulance | 3 Paul Parks Dr, St. Clair, MO 63077 | 2006-12-05 |
| 1821162280 | Kiko Enterprises, LLC | Pharmacy | 920 H St Clair Plaza Dr, St Clair, MO 63077 | 2006-11-20 |
| 1235139221 | Kirk Edward Brockman | Family Medicine | 1001 Cardwell St, St. Clair, MO 63077 | 2005-07-30 |
| 1487869368 | Kamil Dostalik | Physical Therapist | 1135 N Commercial Ave, Saint Clair, MO 63077-1012 | 2007-05-13 |
| 1982914818 | St Clair Physical Therapy Inc | Clinic/Center | 1135 N Commercial Ave, Saint Clair, MO 63077-1012 | 2010-10-13 |
| Find all providers in zip 63077 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820283 | Oak Meadows Rcf LLC | Assisted Living Facility | 5502 Misty Meadow Rd, Poplar Bluff, MO 63901-9287 | 2020-10-28 |
| 1700486859 | Hillcrest Residential Care | Assisted Living Facility | 9415 N North Browns Station Rd, Columbia, MO 65202-8671 | 2020-10-28 |
| 1700484250 | Americare At Field Pointe LLC | Assisted Living Facility | 5002 Gene Field Road, St Joseph, MO 64506 | 2020-10-15 |
| 1205433638 | Skyline Assisted Living LLC | Assisted Living Facility | 100 Hard Rock Rd, Van Buren, MO 63965-0780 | 2020-10-08 |
| 1023615622 | Four Seasons Care Corp | Assisted Living Facility | 230 Railroad St, Moscow Mills, MO 63362-1600 | 2020-10-06 |
| 1336754985 | Tiffany Springs Senior Care Community | Assisted Living Facility | 9101 N Ambassador Dr, Kansas City, MO 64154-7295 | 2020-09-10 |
| 1366053480 | Green Acres Assisted Living LLC | Assisted Living Facility | 411 N Kings Highway, Sikeston, MO 63801-1936 | 2020-08-12 |
| 1467062612 | Welcome Home Assisted Living, LLC | Assisted Living Facility | 5 Adams Dr, Dexter, MO 63841-1985 | 2020-08-03 |
| 1831725142 | Harmony Gardens Residential, LLC | Assisted Living Facility | 539 E Young Ave, Warrensburg, MO 64093-1228 | 2020-03-18 |
| 1386278414 | Family Partners Home LLC | Assisted Living Facility | 232 Creve Coeur Ave, Manchester, MO 63011-4040 | 2020-02-27 |
| Find all providers with the same taxonomy | ||||
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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.