Organization
PINE GROVE MANOR LLC
Active
Other names
Pine Grove Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID GARETZ (CFO)
(323) 987-5954
Entity
Organization
Contact information
Practice address
4359 TAFT AVE, SAINT LOUIS, MO 63116-1533
(314) 752-2022
Mailing address
4359 TAFT AVE, SAINT LOUIS, MO 63116-1533
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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