Grand Manor SNF Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GRAND MANOR SNF OPCO LLC

Doing business as

Grand Manor Health Care Center

Practice address

3645 Cook Ave
Saint Louis, MO 63113-3801

Phone

(314) 531-2352

Fax

(314) 531-7140

NPI assigned

Jun 22, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicholas Destefane

Title

President

Phone

(314) 543-3800

Specialties & licenses 1

Addresses

Other names 1

• Grand Manor Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1194651687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 CRAIG PARK CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 COOK AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631133801",
            "telephone_number": "314-531-2352",
            "fax_number": "314-531-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND MANOR SNF OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "DESTEFANE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-543-3800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Manor Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jorge Granadillo de Luque, MD
• Rachel Elizabeth Granberg, MD, MPH
• Steven J Granberg, MD
• Grand Manor Health Care Center, L.L.C.
• Grand Manor Nursing & Rehabilitation Center, L.L.C.
• Grand Medical Group LLC
• Mark Gilbert Grand, MD
• Allyson M Granden, NP-C
• Laura Granderson
• Grandmom Honey LLC

• Skilled Nursing Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.