GRAND MANOR HEALTH CARE CENTER, L.L.C.
NPI 1215782149
Skilled Nursing Facility in Saint Louis, MO

Active since April 23, 2024CLIA 26D0438791 · Waiver
3645 COOK AVE, SAINT LOUIS, MO 63113(314) 531-2352(314) 531-2352 Get Directions Write a Review

NPPES record last updated: February 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grand Manor Health Care Center, L.l.c. NPPES

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

GRAND MANOR HEALTH CARE CENTER, L.L.C. (NPI 1215782149), doing business as Grand Manor Health Care Center, is a healthcare organization registered as a skilled nursing facility in Saint Louis, Missouri and active in the NPI registry since April 2024. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Richard J. Destefane, President, as its authorized official.

NPPES Registry Identity

NPI1215782149
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGRAND MANOR HEALTH CARE CENTER, L.L.C.
Location Address3645 COOK AVESaint Louis, MO 63113-3801
Mailing Address1869 Craig Park CtSaint Louis, MO 63146-4122 · (314) 543-3816 · Fax (314) 226-1736
Fax(314) 531-2352
Organization SubpartNo
Authorized OfficialRichard J. DestefanePresident · (314) 543-3816
Enumeration DateApril 23, 2024
Last NPPES UpdateFebruary 20, 2026
NPPES CertifiedFebruary 20, 2026
NPI 1215782149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.
3645 COOK AVE, Saint Louis, MO 63113

Other Names 1

Doing Business AsGrand Manor Health Care Center

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 26D0438791

Grand Manor Health Care Center, LLC · Saint Louis, MO
Active · expires Aug 31, 2026
CLIA Number26D0438791
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRobin Allen
Laboratory Phone(314) 531-2352
Laboratory LocationGrand Manor Health Care Center, LLC3645 Cook Ave, Saint Louis, MO 63113
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Skilled Nursing Facility
3645 COOK AVE
SAINT LOUIS, MO 63113
Skilled Nursing Facility
3645 COOK AVE
SAINT LOUIS, MO 63113
Occupational Therapist
3645 COOK AVE
SAINT LOUIS, MO 63113
Physical Therapy Assistant
3645 COOK AVE
SAINT LOUIS, MO 63113

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 Grand Manor Health Care Center, L.L.C.'s NPI number?

The NPI number for Grand Manor Health Care Center, L.L.C. is 1215782149. It was assigned to this organization in the NPPES registry on April 23, 2024. The provider is doing business as Grand Manor Health Care Center.

Where is Grand Manor Health Care Center, L.L.C. located?

Grand Manor Health Care Center, L.L.C. is located at 3645 Cook Ave, Saint Louis, MO 63113. The listed phone number is (314) 531-2352.

What is Grand Manor Health Care Center, L.L.C.'s specialty?

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

Does Grand Manor Health Care Center, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0438791) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grand Manor Health Care Center, L.L.C. was last updated on February 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.