Parc Provence Management, L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

032612 Issued in MO

Legal business name

PARC PROVENCE MANAGEMENT, L.L.C.

Doing business as

Parc Provence

Practice address

605 Coeur de Ville Dr
Creve Coeur, MO 63141-6603

Phone

(314) 542-2500

Fax

(314) 453-7840

NPI assigned

Mar 26, 2007

Last updated

Jun 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Marcia Azar, RN, LNHA

Title

Administrator

Phone

(314) 542-2500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Parc Provence Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1477670008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 COEUR DE VILLE DR",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416603",
            "telephone_number": "314-542-2500",
            "fax_number": "314-453-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 COEUR DE VILLE DR",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416603",
            "telephone_number": "314-542-2500",
            "fax_number": "314-453-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARC PROVENCE MANAGEMENT, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "AZAR",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-542-2500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "032612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SNF LICENSE NO.",
            "identifier": "032612",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "106129406",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY NUMBER",
            "identifier": "24122A",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parc Provence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Creve Coeur, MO
• Providers in Creve Coeur, 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 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.