Supplemental Health Care

Organization Active NPI Adult Care Home Facility · Saint Louis, MO

NPI 1902129653 · NPPES record last updated Mar 9, 2010

Key facts

NPI
1902129653
Entity type
Organization (NPI type 2)
Primary specialty
Adult Care Home Facility 311ZA0620X
License
117346 (MO)
Legal business name
SUPPLEMENTAL HEALTH CARE
Practice address
11960 Westline Industrial Dr
Suite 201
Saint Louis, MO 63146-3209
Phone
(866) 433-9555
Fax
(314) 275-7444
NPI assigned
Mar 9, 2010
Organization subpart
No

Authorized official

Name
Dan Riddle
Title
Recruiting Manager
Phone
(866) 433-9555

Corporate family (same tax ID) 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Practitioners 76

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 76

National Provider Directory

Tax ID family
Supplemental (42 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 117346 MO Yes

Addresses

Primary practice location

11960 Westline Industrial Dr
Suite 201
Saint Louis, MO 63146-3209

Mailing address

11960 Westline Industrial Dr
Suite 201
Saint Louis, MO 63146-3209

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Adult Care Home Facility in Missouri

Sources for this page

Verify at the official NPI Registry.