THE ESTATES OF SPANISH LAKE, LLC (NPI# 1053715995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053715995 |
| Entity Type | Organization |
| Organization Name | THE ESTATES OF SPANISH LAKE, LLC |
| Other Organization Name | THE ESTATES OF SPANISH LAKE |
| Practice Address |
610 Prigge Rd Saint Louis MO 63138-3543 |
| Mailing Address |
5940 W Touhy Ave Ste 350 Niles IL 60714-4638 |
| Practice Telephone | 6108288700 |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2016-03-09 |
| Authorized Official Name | TUVIYAH SPECTOR (MANAGING MEMBER) |
| Authorized Official Telephone | 7733220387 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Estates of Spanish Lake | Doing Business As Name - Organization |
| Street Address |
610 PRIGGE RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63138-3543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942212899 | Green Valley Nursing & Rehabilitation Center LLC | Skilled Nursing Facility | 610 Prigge Rd, Saint Louis, MO 63138-3543 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856396 | D&n Services | Registered Nurse | 1891 Arrowpoint Dr, St Louis, MO 63138 | 2019-11-21 |
| 1902468747 | Sincere Home Health Services | Home Health | 1313 Columbus Dr., Saint Louis, MO 63138 | 2019-07-02 |
| 1053899153 | Nadiyah L Brandon | Driver | 1841 Arrow Point Dr, Saint Louis, MO 63138 | 2018-07-31 |
| 1518489186 | Laconte Randle | Nurse Practitioner | 1225 Lakeview Ave, Saint Louis, MO 63138 | 2017-07-14 |
| 1811369499 | Tyler Musto | Dentist | 120000 Bellefontaine, St. Louis, MO 63138 | 2015-10-22 |
| 1346627106 | Family United Adult Day Center, LLC | Clinic/Center | 12444 Lusher Road, Saint Louis, MO 63138 | 2015-04-30 |
| 1629340765 | Samuel Mugwe Kimari | Specialist | 11838 Orletto Way, St.louis, MO 63138 | 2012-02-06 |
| 1447536453 | Cignodental Care LLP | Dentist | 12000 Bellefontaine, Saint Louis, MO 63138 | 2011-10-24 |
| 1255515995 | Timothy A Schaible Dmd PC | Dentist | 1544 Sierra Vista Plaza, St Louis, MO 63138 | 2007-12-18 |
| 1750406948 | Life Development Support Centers | Day Training, Developmentally Disabled Services | 12259-61 Bellefontaine Road, Saint Louis, MO 63138 | 2007-03-20 |
| Find all providers in zip 63138 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548734627 | Medicore Medical Service LLC | Skilled Nursing Facility | 2303 Kratky Rd Apt B, Saint Louis, MO 63114-1783 | 2019-01-11 |
| 1922458660 | Rebecca Mae Waugh | Skilled Nursing Facility | 1001 Holy Grail Ct, Saint Louis, MO 63125 | 2016-06-14 |
| 1821472069 | Aperion Care Hidden Lake LLC | Skilled Nursing Facility | 11728 Hidden Lake Dr, Saint Louis, MO 63138-1757 | 2015-07-17 |
| 1023241023 | Genesis Rehab Services | Skilled Nursing Facility | 5022 Deville Ave, Saint Louis, MO 63119-4324 | 2009-08-25 |
| 1912197948 | Charla Deiter | Skilled Nursing Facility | 7733 Forsyth Blvd Ste 1700, Saint Louis, MO 63105-1801 | 2007-07-26 |
| 1356565030 | Ebg Health Care I, Inc. | Skilled Nursing Facility | 2939 Magazine St, Saint Louis, MO 63106-1245 | 2007-04-12 |
| 1558585240 | Ebg Health Care II, Inc. | Skilled Nursing Facility | 2900 N Prairie Ave, Saint Louis, MO 63107-2302 | 2007-04-12 |
| 1003933607 | Mcknight Place Extended Care LLC | Skilled Nursing Facility | 2 Mcknight Pl, Saint Louis, MO 63124-1900 | 2007-03-26 |
| 1366570079 | St. Johns Place, Inc. | Skilled Nursing Facility | 3333 Brown Rd, Saint Louis, MO 63114-4327 | 2007-03-02 |
| 1134269301 | Gmg, Inc | Skilled Nursing Facility | 5000 S Broadway, Saint Louis, MO 63111-2015 | 2007-02-07 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63138 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.