Organization Active NPI

Arena Manor, Inc.

  • Assisted Living Facility
  • Saint Louis, MO
National Provider Identifier
1861549099
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
032378 Issued in MO
Legal business name
ARENA MANOR, INC.
Practice address
2614 Utah St
Saint Louis, MO 63118-3103
Phone
(313) 773-3408
Fax
(314) 771-8699
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jodi Pate, PRESIDENT
Title
Director of Nursing
Phone
(314) 773-3408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 032378 MO Primary

Addresses

Primary practice location

2614 Utah St
Saint Louis, MO 63118-3103

Mailing address

2614 Utah St
Saint Louis, MO 63118-3103
Phone (313) 773-3408

Other names 1

  • Silver Spur Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0909709Silver Spur2614 Utah, Saint Louis, MO 63118Certificate of waiverDec 13, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861549099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 UTAH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183103",
            "telephone_number": "313-773-3408",
            "fax_number": "314-771-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 UTAH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631183103",
            "telephone_number": "313-773-3408",
            "fax_number": "314-771-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARENA MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "314-773-3408",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PRESIDENT"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "032378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silver Spur",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • 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.
  • 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.