Ellisville Opco LLC
NPI #1275372088 in Ellisville, Missouri
Provider Information
- NPI Number
- 1275372088
- Entity Type
- Organization
- Organization Name
- Ellisville Opco LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- May 21, 2024
- Last Updated
- May 23, 2024
Practice Location
- Address
- 322 OLD STATE RD
- City
- Ellisville
- State
- Missouri
- ZIP Code
- 63021-5917
- Phone
- (636) 227-3431
Authorized Official
- Name
- ELAZAR FISCHER
- Title
- MANAGER
- Phone
- (636) 227-3431
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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