Russell

LBN: Magdala Foundation
Russell is an health care organization with primary practice located at 4242 Russell Blvd , Saint Louis MO 63110-3511. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Magdala Foundation can be contacted via phone (314) 652-6004, or through Meyer, David via phone (314) 652-6004.

Contact Information

Primary practice address
4242 Russell Blvd Saint Louis MO 63110-3511
Phone: (314) 652-6004
Fax: (314) 652-8351
Website:
Map and Directions
Authorized official contact:
Name: Meyer, David
Phone: (314) 652-6004

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 2452 10042 Missouri

Profile Details

NPI number 1255599528
LBN Legal business name Magdala Foundation
DBA Doing business as Russell
Authorized official Meyer, David
Entity Organization
Organization subpart 1 Yes
Enumeration date May 23rd, 2008
Last updated May 23rd, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255599528 NPPES
Missouri MEDICAID 112364401

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