Organization
HIDDEN LAKE HEALTH CARE CENTER, LLC
Active
Organization
HIDDEN LAKE HEALTH CARE CENTER, LLC
Active
Other names
Hidden Lake Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J. DESTEFANE (PRESIDENT)
(314) 543-3805
Entity
Organization
Contact information
Practice address
11728 HIDDEN LAKE DR, SAINT LOUIS, MO 63138-1765
(314) 355-8833
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
09/12/2025
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