Provider Demographics
NPI:1518389048
Name:VILLAGES OF ST PETERS LLC
Entity Type:Organization
Organization Name:VILLAGES OF ST PETERS LLC
Other - Org Name:THE VILLAGES OF ST PETERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-946-3677
Mailing Address - Street 1:5400 EXECUTIVE CENTRE PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5400 EXECUTIVE CENTRE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2594
Practice Address - Country:US
Practice Address - Phone:636-922-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-17
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
265824Medicare Oscar/Certification