Victorian Manor of St Clair

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

036029 Issued in MO

Legal business name

VICTORIAN MANOR OF ST CLAIR

Practice address

160 Charles Dr
St Clair, MO 63077

Phone

(636) 322-0003

Fax

(636) 322-0006

NPI assigned

Oct 15, 2008

Organization subpart

No

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

Authorized official

Name

Nancy L Quick

Title

Secretary

Phone

(573) 437-2103

Specialties & licenses 1

Addresses

Other names 1

• Victorian Manor of St Clair Other name

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224028800000",
    "number": "1568614063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 SPRINGFIELD RD",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650661015",
            "telephone_number": "573-437-2103",
            "fax_number": "573-437-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CHARLES DR",
            "city": "ST CLAIR",
            "state": "MO",
            "postal_code": "63077",
            "telephone_number": "636-322-0003",
            "fax_number": "636-322-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIAN MANOR OF ST CLAIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A",
        "authorized_official_last_name": "QUICK",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "573-437-2103"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "036029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victorian Manor of St Clair",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• St. Clair Ambulance District
• St. Clair Reorganized District R-Xiii
• Jennifer Kaye Stenger, OTR
• Town and Country Mobility Inc.
• Sophie A. Vaughn, M.S., CF-SLP
• Luke Weber, PHARM.D.
• Patsy Weber, M.A., LPC
• Clara Marie Wilson, OTR/L

• Assisted Living Facility in St Clair, MO
• Providers in St Clair, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; 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.