Provider Demographics
NPI:1851593461
Name:SAN FRANCISCO TEMPLE MULTIPLEX
Entity Type:Organization
Organization Name:SAN FRANCISCO TEMPLE MULTIPLEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:CECELIA
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-383-4863
Mailing Address - Street 1:5341 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63120-2511
Mailing Address - Country:US
Mailing Address - Phone:314-383-4863
Mailing Address - Fax:314-381-4255
Practice Address - Street 1:5341 EMERSON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63120-2511
Practice Address - Country:US
Practice Address - Phone:314-383-4863
Practice Address - Fax:314-381-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO392311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility