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Organization

ESTATES OF HIDDEN LAKE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LEVI ISRAEL (CEO)
(847) 905-3000
Entity
Organization

Contact information

Practice address
11728 HIDDEN LAKE DR, ST. LOUIS, MO 63138
(314) 355-8833
Mailing address
11728 HIDDEN LAKE DR, ST. LOUIS, MO 63138
(314) 355-8833

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
02/05/2020
Last updated
08/11/2025
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