Organization
COMMUNITY CARE CTR OF SULLIVAN, INC
Active
Other names
Meramec Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA M GIARDINA (PRESIDENT)
(636) 394-3000
Entity
Organization
Contact information
Practice address
940 MATTOX DR, SULLIVAN, MO 63080-2364
(573) 468-7733
(573) 860-3168
Mailing address
437 SOVEREIGN CT, BALLWIN, MO 63011-4432
(636) 394-3000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
033721
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106830706
—
MO
Enumeration date
06/30/2005
Last updated
03/04/2021
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