Organization
MARY RYDER HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEFANIE OSIEK (ADMINISTRATOR)
(314) 531-2981
Entity
Organization
Contact information
Practice address
4361 OLIVE ST, SAINT LOUIS, MO 63108-2621
(314) 531-2981
(314) 531-2990
Mailing address
4361 OLIVE ST, SAINT LOUIS, MO 63108-2621
(314) 531-2981
(314) 531-2990
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
253Z00000X
In Home Supportive Care Agency
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
032674
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266740513
—
MO
Enumeration date
05/17/2007
Last updated
06/04/2019
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