OrganizationActive
Supplemental Health Care
NPI 1902129653 · Adult Care Home Facility · Saint Louis, MO
Provider details
- NPI number
- 1902129653
- Entity type
- Organization
- Primary specialty
- Adult Care Home FacilityNursing & Custodial Care Facilities
- Authorized official
- Dan Riddle, Recruiting Manager
- License
- 117346 (MO)
Practice location
11960 Westline Industrial Dr
Suite 201
Saint Louis, MO 63146-3209
Phone: (866) 433-9555
Fax: (314) 275-7444
Mailing address
11960 Westline Industrial Dr
Saint Louis, MO 63146-3209
Registry dates
- Enumerated
- 2010-03-09
- Last updated
- 2010-03-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.