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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