Provider Demographics
NPI:1366500555
Name:CARDINAL RITTER SENIOR SERVICES ADULT HEALTH DAY PROGRAM
Entity Type:Organization
Organization Name:CARDINAL RITTER SENIOR SERVICES ADULT HEALTH DAY PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:MANTIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-961-8000
Mailing Address - Street 1:7601 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-5001
Mailing Address - Country:US
Mailing Address - Phone:314-962-7501
Mailing Address - Fax:314-962-7140
Practice Address - Street 1:7663 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-5038
Practice Address - Country:US
Practice Address - Phone:314-962-7501
Practice Address - Fax:314-962-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO655385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care