CREVE COEUR MANOR LLC
NPI 1194806109
Skilled Nursing Facility in Saint Louis, MO

Active since October 17, 2006CLIA 26D0991754 · Waiver
1127 TIMBER RUN DR, SAINT LOUIS, MO 63146(314) 434-8361(314) 434-7785 Get Directions Write a Review

NPPES record last updated: December 17, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Creve Coeur Manor Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CREVE COEUR MANOR LLC (NPI 1194806109) is a healthcare organization registered as a skilled nursing facility in Saint Louis, Missouri and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through September 26, 2027 and lists Sharo Shirshekan, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1194806109
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCREVE COEUR MANOR LLC
Location Address1127 TIMBER RUN DRSaint Louis, MO 63146-4482
Mailing Address1127 Timber Run DrSaint Louis, MO 63146-4482 · (314) 434-8361 · Fax (314) 434-7785
Fax(314) 434-7785
Organization SubpartNo
Authorized OfficialSharo ShirshekanManaging Member · (573) 701-0600
Enumeration DateOctober 17, 2006
Last NPPES UpdateDecember 17, 2013
NPI 1194806109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MO · 031651
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

1127 TIMBER RUN DR, Saint Louis, MO 63146

Other Identifiers 2

Medicare OSCAR/certification265720MO
Medicaid101486009MO

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0991754

Palladian Creve Coeur, LLC D/B/A Creve Coeur Manor · Saint Louis, MO
Active · expires Sep 26, 2027
CLIA Number26D0991754
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 27, 2025
Certificate Expiration DateSeptember 26, 2027
Laboratory DirectorCynthia Barker
Laboratory Phone(312) 994-2306
Laboratory LocationPalladian Creve Coeur, LLC D/B/A Creve Coeur Manor1127 Timber Run Dr, Saint Louis, MO 63146
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Physical Therapist
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Occupational Therapy Assistant
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Skilled Nursing Facility
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Skilled Nursing Facility
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Creve Coeur Manor LLC's NPI number?

The NPI number for Creve Coeur Manor LLC is 1194806109. It was assigned to this organization in the NPPES registry on October 17, 2006.

Where is Creve Coeur Manor LLC located?

Creve Coeur Manor LLC is located at 1127 Timber Run Dr, Saint Louis, MO 63146. The listed phone number is (314) 434-8361.

What is Creve Coeur Manor LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Creve Coeur Manor LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0991754) is associated with this NPI, valid through September 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Creve Coeur Manor LLC was last updated on December 17, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.