Organization
OSMAN LLC
Active
Other names
country haven asissted living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALI CHAUDHRY (MANAGING MEMBER)
(314) 630-2414
Entity
Organization
Contact information
Practice address
19235 STATE ROUTE EE, STE GENEVIEVE, MO 63670-8213
(673) 756-8141
(573) 756-9141
Mailing address
2322 MUELLER LN, SAINT LOUIS, MO 63131-1411
(314) 630-2414
(314) 991-0096
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
035466
MO
320800000X
Mental Illness Community Based Residential Treatment Facility
035469
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263344905
PERSONAL CARE PROVIDER
MO
01
—
263344913
PERSONAL CARE PROVIDER
MO
Enumeration date
10/19/2007
Last updated
05/14/2008
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