U-City Forest Manor, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

032190 Issued in MO

Legal business name

U-CITY FOREST MANOR, LLC

Practice address

1301 Partridge Ave
Saint Louis, MO 63130-1944

Phone

(314) 862-5556

Fax

(314) 862-2951

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Sharo Shirshekan

Title

Managing Member

Phone

(573) 701-0600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1801984885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 WEBER RD",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636403318",
            "telephone_number": "573-701-0600",
            "fax_number": "573-701-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PARTRIDGE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631301944",
            "telephone_number": "314-862-5556",
            "fax_number": "314-862-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U-CITY FOREST MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "SHIRSHEKAN",
        "authorized_official_first_name": "SHARO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "573-701-0600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "032190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102757200",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Dec 17, 2013; 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.