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32 Portwest Ct Saint Charles MO 63303-5985 | |
| (314) 280-6366 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Custodial Care Facility - Adult Care Home |
| Location | 32 Portwest Ct, Saint Charles, Missouri |
| Authorized Official Name and Position | Tanika Esters (REGISTERED NUSE) |
| Authorized Official Contact | 3147244354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
32 Portwest Ct Saint Charles MO 63303-5985 Ph: (314) 280-6366 | 32 Portwest Ct Saint Charles MO 63303-5985 Ph: (314) 280-6366 |
| NPI Number | 1124866314 |
|---|---|
| Provider Enumeration Date | 07/19/2024 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124866314 | NPI | - | NPPES |
| 119342180 | Medicaid | MO | |
| 822675050 | Medicaid | MO |
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