AVALON MEMORY CARE, LLC (NPI# 1790295558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790295558 |
| Entity Type | Organization |
| Organization Name | AVALON MEMORY CARE, LLC |
| Practice Address |
5342 Butler Hill Rd Saint Louis MO 63128-4152 |
| Mailing Address |
1625 N Stemmons Fwy Dallas TX 75207-3411 |
| Practice Telephone | 3148492960 |
| Mailing Telephone | 2147527050 |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |
| Authorized Official Name | MR. JONATHAN SEIB (MANAGER) |
| Authorized Official Telephone | 2147527050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 045258 | MO | Nursing & Custodial Care Facilities |
| Street Address |
5342 BUTLER HILL RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-4152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912462037 | Dunn-dunn House LLC | Assisted Living Facility | 2133 Jannette Dr, Saint Louis, MO 63136-4020 | 2019-02-02 |
| 1932608932 | Sw Living LLC | Assisted Living Facility | 1501 Clinton St, Saint Louis, MO 63106-4100 | 2018-02-05 |
| 1275074957 | Americare At South St. Louis, LLC | Assisted Living Facility | 4962 Mattis Rd, Saint Louis, MO 63128-2795 | 2017-03-15 |
| 1326400888 | Shonta Clark | Assisted Living Facility | 325 Rose Ln, Saint Louis, MO 63122-5911 | 2016-03-24 |
| 1184001836 | Carondelet Retirement Manor | Assisted Living Facility | 6811 Michigan Ave, Saint Louis, MO 63111-2834 | 2015-05-01 |
| 1275910341 | Holly Hills Retirement Home | Assisted Living Facility | 6421 Minnesota Ave, Saint Louis, MO 63111-2808 | 2015-04-28 |
| 1487044293 | Neelum LLC | Assisted Living Facility | 3610 Palm St, Saint Louis, MO 63107-2206 | 2015-02-01 |
| 1104235548 | Garden Villas of South County, Inc. | Assisted Living Facility | 13457 Tesson Ferry Rd, Saint Louis, MO 63128-4010 | 2014-08-11 |
| 1124439708 | St. Anthony's Physician Organization | Assisted Living Facility | 9735 Landmark Parkway Dr Ste 200, Saint Louis, MO 63127-1666 | 2014-05-16 |
| 1245670512 | Mcknight Place Assisted Living, L.L.C. | Assisted Living Facility | 3 Mcknight Pl, Saint Louis, MO 63124-1900 | 2013-07-01 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.