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Organization
SUPPLEMENTAL HEALTH CARE
Active
Organization
SUPPLEMENTAL HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN RIDDLE (RECRUITING MANAGER)
(866) 433-9555
Entity
Organization
Contact information
Practice address
11960 WESTLINE INDUSTRIAL DR, SUITE 201, SAINT LOUIS, MO 63146-3209
(866) 433-9555
(314) 275-7444
Mailing address
11960 WESTLINE INDUSTRIAL DR, SUITE 201, SAINT LOUIS, MO 63146-3209
(314) 275-7444
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
117346
MO
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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