- Enrollment id
- O20230518002848
- Enrollment state
- MO
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1588325765
- Multiple npi flag
- N
- Ccn
- 265736
- Associate id
- 5395101281
- Organization name
- PALLADIAN UCITY LLC
- Doing business as name
- U-CITY FOREST MANOR
- Incorporation date
- 2021-10-05
- Incorporation state
- IL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- U-CITY FOREST MANOR
- Affiliation entity name
- PALLADIAN HEALTHCARE
- Affiliation entity id
- 393
- Address line 1
- 1301 PARTRIDGE AVE
- City
- SAINT LOUIS
- State
- MO
- Zip code
- 631301944