Eldercare of Marble Hill, LLC
Organization Active NPI Skilled Nursing Facility · Marble Hill, MO
NPI 1902803232 · NPPES record last updated Dec 1, 2020
Key facts
- NPI
- 1902803232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- ELDERCARE OF MARBLE HILL, LLC
- Practice address
- 702 Highway 34 W
Marble Hill, MO 63764-4301 - Phone
- (573) 238-2614
- Fax
- (573) 238-9835
- NPI assigned
- Jul 1, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Mark Lierman
- Title
- Authorized Official
- Phone
- (636) 477-3280
Owners & managing parties with NPI records 1
-
James Richard Palen, M.D.
Facilities with the same owner 11
Practitioners 2
-
Shawn Michael Gao, M.D.
-
James E Palen, M.D.
Affiliated clinicians 1
-
James E Palen, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Stonebridge Marble Hill
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Oct 21, 1993
- Medicare certification status
- Active
- Certified beds
- 98 · 69.0 residents per day on average
- Chain
- Stonebridge Senior Living
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0663479 | Eldercare of Marble Hill LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Skilled nursing facility certification: CCN 265553
- Legal name
- ELDERCARE OF MARBLE HILL, LLC
- Doing business as
- STONEBRIDGE MARBLE HILL
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 21, 1993
- Last certification
- Sep 13, 2024
- Beds
- 98
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 702 Highway 34 W
Marble Hill, MO 63764-4301 - Nursing home name
- STONEBRIDGE MARBLE HILL
- Affiliated entity
- STONEBRIDGE SENIOR LIVING
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Beth Miller |
Adp of the SNF | Jan 17, 2023 | |
| Eric Doerhoff |
Operational/Managerial Control |
Nov 1, 2021 | 50% |
| Adp of the SNF | Nov 1, 2021 | ||
| Enterprise Bank & Trust |
Operational/Managerial Control | May 30, 2008 | |
| Eldercare Management Services Inc |
Operational/Managerial Control | Mar 29, 1999 | |
| Adp of the SNF | Apr 22, 2025 | ||
| Jeanne Thayer |
Operational/Managerial Control | Nov 1, 2021 | |
| Adp of the SNF | Nov 1, 2021 | ||
| Renee Ellis |
Operational/Managerial Control | Jun 1, 2016 | |
| Adp of the SNF | Jun 1, 2016 | ||
| Wipfli LLP |
Adp of the SNF | Jan 1, 2025 | |
| Abbey Jansen |
Operational/Managerial Control | Aug 19, 2024 | |
| Adp of the SNF | Aug 19, 2024 | ||
| Kellie Cook |
Adp of the SNF | Jul 7, 2011 | |
| Bridge Rehabilitation Inc |
Operational/Managerial Control | Feb 1, 2024 | |
| Adp of the SNF | Apr 22, 2025 | ||
| Mark W Lierman |
5% Or Greater Direct Ownership Interest | Nov 1, 2021 | 100% |
| Corporate Officer |
Nov 1, 2021 | 100% | |
| Operational/Managerial Control | Nov 1, 2021 | ||
| Adp of the SNF | Nov 1, 2021 | ||
| Forvis Mazars LLP |
Adp of the SNF | Jan 25, 2016 | |
| James R Palen |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Lierman Family Partnership II |
Adp of the SNF | Oct 1, 1999 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100119000611 | MO | Part a Provider - Skilled Nursing Facility | 8123160868 | Practice locations: Marble Hill, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
702 Highway 34 W
Marble Hill, MO 63764-4301
Mailing address
702 Highway 34 W
Marble Hill, MO 63764-4301
Phone (636) 477-3280
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102069408 | Medicaid | MO |
Other names
- StoneBridge Marble Hill
Other providers in Marble Hill, MO
- Diana'S Boarding Home, Inc
- Diana'S Boarding Home, Inc
- Dianas Boarding Home Inc
- David Lee Downey Jr.
- Sarah Jalil Downey
- Julie Elfrink
- Jennifer Kathleen Garland
- Alyssa Naschell Grado
- Michael Wayne Green
- Kristine Ann Hawkins
All providers in Marble Hill, MO · Skilled Nursing Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.