Provider Demographics
NPI:1720012347
Name:ST. ANDREW'S AT FRANCIS PLACE
Entity Type:Organization
Organization Name:ST. ANDREW'S AT FRANCIS PLACE
Other - Org Name:ST. ANDREW'S AT FRANCIS PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-726-2773
Mailing Address - Street 1:300 FORBY ROAD
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-0476
Mailing Address - Country:US
Mailing Address - Phone:636-938-5151
Mailing Address - Fax:636-938-5266
Practice Address - Street 1:300 FORBY ROAD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-0476
Practice Address - Country:US
Practice Address - Phone:636-938-5151
Practice Address - Fax:636-938-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO031926314000000X
MO041491314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101780708Medicaid
MO128722OtherBLUE CROSS/BLUE SHIELD
265195Medicare Oscar/Certification
MO265195Medicare Oscar/Certification