Organization
PARK AVENUE SNF OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS DESTEFANE (PRESIDENT)
(314) 543-3800
Entity
Organization
Contact information
Practice address
146 PARK AVE, ARLINGTON, MA 02476-5829
(781) 648-9530
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
(314) 543-3805
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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