Provider Demographics
NPI:1275074957
Name:AMERICARE AT SOUTH ST. LOUIS, LLC
Entity Type:Organization
Organization Name:AMERICARE AT SOUTH ST. LOUIS, LLC
Other - Org Name:MATTIS POINTE ASSISTED LIVING BY AMERICARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-471-1113
Mailing Address - Street 1:4962 MATTIS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2795
Mailing Address - Country:US
Mailing Address - Phone:573-471-1113
Mailing Address - Fax:
Practice Address - Street 1:4962 MATTIS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2795
Practice Address - Country:US
Practice Address - Phone:573-471-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility