Organization
EDEN MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE NICOLE ROSS (EXECUTIVE DIRECTOR)
(314) 814-2594
Entity
Organization
Contact information
Practice address
1361 ARLINGTON AVE, SAINT LOUIS, MO 63112-4131
(314) 833-4313
(314) 833-4313
Mailing address
1361 ARLINGTON AVE, SAINT LOUIS, MO 63112-4131
(314) 833-4313
(314) 833-4313
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
LC9786208
MO
Other
Enumeration date
04/17/2016
Last updated
04/17/2016
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