OrganizationActive
Hidden Lake Health Care Center, LLC
NPI 1104716190 · Assisted Living Facility · Saint Louis, MO
Provider details
- NPI number
- 1104716190
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Richard Destefane, President(314) 543-3805
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11728 Hidden Lake Dr
Saint Louis, MO 63138-1765
Phone: (314) 355-8833
Street-level locationGet directions
Mailing address
1869 Craig Park Ct
Saint Louis, MO 63146-4122
Other names (DBA / former)
- Doing business as
- Hidden Lake Health Care Center
Registry dates
- Enumerated
- 2025-07-09
- Last updated
- 2025-09-12
- Certified
- 2025-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.