Organization
NORTH VILLAGE PARK, LLC
Active
Other names
North Village Park
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ASHWIN DUNDOO (FINANCE)
(314) 543-3800
Entity
Organization
Contact information
Practice address
2041 SILVA LN, MOBERLY, MO 65270-3658
(660) 263-1894
(660) 263-0751
Mailing address
1869 CRAIG PARK CT, SAINT LOUIS, MO 63146-4122
(314) 543-3800
(314) 543-3880
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102561404
—
MO
Enumeration date
10/06/2005
Last updated
05/30/2013
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