Organization
LIVING LIFE LONG RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRONE L. BEATTY (MANAGING PARTNER)
(314) 497-5284
Entity
Organization
Contact information
Practice address
5076 WATERMAN BLVD, SAINT LOUIS, MO 63108-1102
(314) 495-5498
(866) 883-0221
Mailing address
303 UNION BLVD STE 300, SAINT LOUIS, MO 63108-4402
(314) 495-5498
(866) 883-0221
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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