Organization
U-CITY FOREST MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARO SHIRSHEKAN (MANAGING MEMBER)
(573) 701-0600
Entity
Organization
Contact information
Practice address
1301 PARTRIDGE AVE, SAINT LOUIS, MO 63130-1944
(314) 862-5556
(314) 862-2951
Mailing address
765 WEBER RD, FARMINGTON, MO 63640-3318
(573) 701-0600
(573) 701-0601
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
032190
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102757200
—
MO
Enumeration date
10/11/2006
Last updated
12/17/2013
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