Organization
GRAND MANOR HEALTH CARE CENTER, L.L.C.
Active
Other names
Grand Manor Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD J. DESTEFANE (PRESIDENT)
(314) 543-3816
Entity
Organization
Contact information
Practice address
3645 COOK AVE, SAINT LOUIS, MO 63113-3801
(314) 531-2352
(314) 531-2352
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
(314) 543-3816
(314) 226-1736
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/23/2024
Last updated
02/20/2026
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