Organization
CREVE COEUR MANOR HEALTH CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J. DESTEFANE (PRESIDENT)
(314) 543-3805
Entity
Organization
Contact information
Practice address
1127 TIMBER RUN DR, SAINT LOUIS, MO 63146-4482
(314) 434-8361
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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