Organization
MANOR GROVE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA D ERRICO MSN, LNHA (ADMINISTRATOR)
(314) 965-0864
Entity
Organization
Contact information
Practice address
711 S KIRKWOOD RD, KIRKWOOD, MO 63122
(314) 965-0864
(314) 965-0464
Mailing address
711 S KIRKWOOD RD, KIRKWOOD, MO 63122-5928
(314) 965-0864
(314) 965-0464
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
031653
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031653
STATE OPERATING LICENSE
MO
05
—
102191806
—
MO
Enumeration date
02/09/2007
Last updated
08/02/2018
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