Organization
LOMA LINDA HEALTH CARE CENTER, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD J DESTEFANE (PRESIDENT)
(314) 543-3800
Entity
Organization
Contact information
Practice address
1600 E ROLLINS ST, MOBERLY, MO 65270-2478
(660) 263-6887
(660) 263-8823
Mailing address
9200 WATSON RD, SUITE 201, SAINT LOUIS, MO 63126-1528
(314) 543-3800
(314) 543-3880
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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