Organization
MMA HEALTHCARE OF ST. ELIZABETH, INC.
Active
Other names
St. Elizabeth Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ASHWIN DUNDOO (FINANCE)
(314) 543-3800
Entity
Organization
Contact information
Practice address
649 S WALNUT STREET, ST. ELIZABETH, MO 65075-2440
(573) 493-2215
(573) 493-2712
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
(314) 543-3800
(314) 543-3880
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
034857
MO
314000000X
Skilled Nursing Facility
Primary
038104
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101477305
—
MO
Enumeration date
12/03/2007
Last updated
04/04/2013
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