Provider Demographics
NPI:1659181154
Name:NORTONVILLE ASSISTED LIVING, L.L.C.
Entity type:Organization
Organization Name:NORTONVILLE ASSISTED LIVING, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:DESTEFANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-422-7910
Mailing Address - Street 1:1869 CRAIG PARK CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4122
Mailing Address - Country:US
Mailing Address - Phone:314-543-3816
Mailing Address - Fax:314-226-1736
Practice Address - Street 1:415 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:NORTONVILLE
Practice Address - State:KS
Practice Address - Zip Code:66060-4008
Practice Address - Country:US
Practice Address - Phone:913-886-6400
Practice Address - Fax:913-886-8695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility