Senior Residential, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

033895 Issued in MO

Legal business name

SENIOR RESIDENTIAL, LLC

Practice address

3409 Missouri Ave
Saint Louis, MO 63118-3236

Phone

(314) 771-8360

NPI assigned

Mar 31, 2007

Organization subpart

No

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

Authorized official

Name

David L Nolting

Title

Manager

Phone

(314) 771-8360

Specialties & licenses 1

Addresses

Other names 1

• New Heights Residential Care Doing business as

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699895615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633760005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 MISSOURI AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183236",
            "telephone_number": "314-771-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOLTING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "314-771-8360"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "MO",
            "license": "033895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Heights Residential Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Custodial Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.