Provider Demographics
NPI:1194843268
Name:LITTLE SISTERS OF THE POOR
Entity Type:Organization
Organization Name:LITTLE SISTERS OF THE POOR
Other - Org Name:SAINT LOUIS RESIDENCE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OF THE CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:SR. MARY SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-421-6022
Mailing Address - Street 1:3225 N FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63107-3521
Mailing Address - Country:US
Mailing Address - Phone:314-421-6022
Mailing Address - Fax:314-421-5936
Practice Address - Street 1:3225 N FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63107-3521
Practice Address - Country:US
Practice Address - Phone:314-421-6022
Practice Address - Fax:314-421-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility