Organization
ALEXIAN BROTHERS SHERBROOKE VILLAGE
Active
Other names
Ascension Living Sherbrooke Village
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE GRONEFELD (COO)
(314) 729-3500
Entity
Organization
Contact information
Practice address
4005 RIPA AVE, SAINT LOUIS, MO 63125-2378
(314) 544-1111
Mailing address
4005 RIPA AVE, SAINT LOUIS, MO 63125-2378
(314) 544-1111
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102781804
—
MO
01
—
128655
BLUE CROSS
—
Enumeration date
11/28/2006
Last updated
06/28/2024
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