Organization
SIRO OP ROYAL OAK LLC
Active
Other names
Royal Oak Nursing & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL GOLDNER (AUTHORIZED OFFICIAL)
(516) 727-1634
Entity
Organization
Contact information
Practice address
4960 LACLEDE AVE, SAINT LOUIS, MO 63108-1404
(314) 361-6240
(314) 361-6682
Mailing address
22 HERRICK DR, LAWRENCE, NY 11559-1528
(516) 727-1634
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/14/2019
Last updated
03/14/2019
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