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Contact Information

FIESER NURSING CENTER LLC
404 MAIN STREET
FENTON, MO63026
 Phone: 636-343-4344
 Fax: 636-349-4536
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for FIESER NURSING CENTER LLC

NPI # 1073693826
LBN Legal business name FIESER NURSING CENTER LLC
Authorized official GLEN FIESER - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/16/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MO License # 032681
MO Medicaid 26A490
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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