NORTHEASTERN NURSING & REHABILITATION CENTER LLC (NPI# 1891024691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891024691 |
| Entity Type | Organization |
| Organization Name | NORTHEASTERN NURSING & REHABILITATION CENTER LLC |
| Other Organization Name | WILLOWBROOKE NURSING & REHABILITATION CENTER |
| Practice Address |
2600 Redman Rd Saint Louis MO 63136-5863 |
| Mailing Address |
1625 S 6th St Springfield IL 62703-2828 |
| Practice Telephone | 3143558585 |
| Practice Fax Number | 3143554645 |
| Mailing Telephone | 2175282244 |
| Mailing Fax Number | 2175283412 |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2010-03-01 |
| Authorized Official Name | MR. ROBERT G HEDGES (MANAGING MEMBER OF LLC) |
| Authorized Official Telephone | 2175282244 |
| 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 |
|---|---|
| Willowbrooke Nursing & Rehabilitation Center | Doing Business As Name - Organization |
| Street Address |
2600 REDMAN RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63136-5863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780679555 | Cathedral Gardens Care Center | Skilled Nursing Facility | 2600 Redman Rd, Saint Louis, MO 63136-5863 | 2005-09-16 |
| 1851881692 | Srz Op St. Louis LLC | Skilled Nursing Facility | 2600 Redman Rd, Saint Louis, MO 63136-5863 | 2018-05-17 |
| 1568897817 | St Louis Health Care LLC | Skilled Nursing Facility | 2600 Redman Rd, Saint Louis, MO 63136-5863 | 2013-09-05 |
| 1629368477 | Benchmark Healthcare of Willowbrooke, LLC | Skilled Nursing Facility | 2600 Redman Rd, Saint Louis, MO 63136-5863 | 2011-04-13 |
| 1508910118 | Cathedral Rock of North St Louis, Inc. | Skilled Nursing Facility | 2600 Redman Rd, Saint Louis, MO 63136-5863 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565993 | Dorothy Smith | Home Health | 2531 Nathan Drive, St Louis, MO 63136 | 2020-10-16 |
| 1538784459 | Rita D Wilson | Technician | 9597 Jacobi Ave Bldg 33 Apt 7, Saint Louis, MO 63136 | 2020-06-16 |
| 1922646728 | Eduhealth Personal Care Services | Technician | 5843 Eagle Valley Dr Saint Louis Mo 63136, Saint Louis, MO 63136 | 2019-12-12 |
| 1558912964 | Homers Haven Home Care LLC | Home Health | 5636 Pamplin Pl, St Louis, MO 63136 | 2019-09-26 |
| 1366096703 | Chloe Suzanne Datillo | Nurse Practitioner | 2865 Netherton Dr., St Louis, MO 63136 | 2019-07-24 |
| 1053976431 | U Auto Be Quik LLC | Non-emergency Medical Transport (VAN) | 10352 Castle Drive, St. Louis, MO 63136 | 2019-05-01 |
| 1164945895 | A Plus Home Health Services LLC | Home Health | 9517 Wilson Bridge Drive, Saint Louis, MO 63136 | 2017-07-25 |
| 1184150302 | Fairview Village Adult Day Care LLC | Clinic/Center | 8449 Jennings Station Rd, Fairview Village Adult Day Care, Saint Louis, MO 63136 | 2017-05-08 |
| 1023541182 | Lots of Love Home Health Services | In Home Supportive Care | 4144 Lindell Blvd. Suite 218, Saint Louis, MO 63136 | 2017-04-06 |
| 1912440876 | Carestl Health | Clinic/Center | 7047 Emma Ave, Jennings, MO 63136 | 2016-11-28 |
| Find all providers in zip 63136 | ||||
| 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 | 63136 |
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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.