Organization
CRESTWOOD HEALTH CARE CENTER, L.L.C.
Active
Other names
Crestwood Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ASHWIN DUNDOO (FINANCE)
(314) 543-3800
Entity
Organization
Contact information
Practice address
11400 MEHL AVENUE, FLORISSANT, MO 63033-7204
(314) 741-3525
(314) 741-3721
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
(314) 543-3800
(314) 543-3880
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
038173
MO
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102504701
—
MO
Enumeration date
02/15/2008
Last updated
04/04/2013
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