Organization
ELDERCARE OF MARBLE HILL, LLC
Active
Other names
StoneBridge Marble Hill
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK LIERMAN (AUTHORIZED OFFICIAL)
(636) 477-3280
Entity
Organization
Contact information
Practice address
702 HIGHWAY 34 W, MARBLE HILL, MO 63764-4301
(573) 238-2614
(573) 238-9835
Mailing address
702 HIGHWAY 34 W, MARBLE HILL, MO 63764-4301
(636) 477-3280
(636) 477-3241
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102069408
—
MO
Enumeration date
07/01/2005
Last updated
12/01/2020
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