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MIZPAH ASSISTED LIVING SERVICES NPI 1508056425


NPI Information

NPI: 1508056425
Provider Name: MIZPAH ASSISTED LIVING SERVICES

Doing Business As: MIZPAH MANOR

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 26D0968712

Address:
11325 SAINT CHARLES ROCK RD
BRIDGETON, MO
ZIP 63044
Phone: (314) 209-1177
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MIZPAH ASSISTED LIVING SERVICES is an assisted living facility in Bridgeton, MO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. MIZPAH ASSISTED LIVING SERVICES NPI is 1508056425. The provider is registered as an organization entity type.
The provider Is Doing Business As Mizpah Manor.

The provider's business location address is:

11325 SAINT CHARLES ROCK RD
BRIDGETON, MO
ZIP 63044-722
Phone: (314) 209-1177
Fax: (314) 738-0777

The provider's authorized official is Julie Klein .
The authorized official title is Administrator and has the following contact phone number (314) 209-1177.

The CLIA number assigned to this NPI record is 26D0968712 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2007 and was last updated on 7/26/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility032466MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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