Organization
GREEN PARK LEASING CO., LLC
Active
Other names
Green Park Senior Living Community
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA K HUBBARD (DIR OF A/R)
(513) 530-1327
Entity
Organization
Contact information
Practice address
9350 GREEN PARK RD, SAINT LOUIS, MO 63123-7211
(314) 845-0900
(314) 845-0901
Mailing address
4700 ASHWOOD DR, SUITE 200, CINCINNATI, OH 45241-2465
(513) 489-7100
(513) 530-1359
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031930
MO
320700000X
Physical Disabilities Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107808008
—
MO
Enumeration date
11/30/2006
Last updated
09/29/2022
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