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Organization

FOSTORIA AL OPCO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS E DESTEFANE (PRESIDENT)
(314) 543-3800
Entity
Organization

Contact information

Practice address
1000 INDEPENDENCE AVE, FOSTORIA, OH 44830-9614
(419) 435-8505
(419) 435-0829
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
(314) 226-1736

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
03/04/2026
Last updated
03/04/2026
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