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GARDEN VILLAS NORTH
NPI 1497164834
Assisted Living Facility in Black Jack, MO

Active since August 11, 2014CLIA 26D2071712 · Waiver
4505 PARKER RD, BLACK JACK, MO 63033(314) 355-6100(314) 355-1463 Get Directions Write a Review

NPPES record last updated: August 11, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Garden Villas North NPPES

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

GARDEN VILLAS NORTH (NPI 1497164834) is a healthcare organization registered as an assisted living facility in Black Jack, Missouri and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through January 16, 2028 and lists Gail Lee Hartmann, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1497164834
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameGARDEN VILLAS NORTH, LLC
Location Address4505 PARKER RDBlack Jack, MO 63033-4268
Mailing Address14805 N Outer 40 Rd, Suite 300Chesterfield, MO 63017-6060 · (636) 733-7000 · Fax (636) 733-7010
Phone(314) 355-6100
Fax(314) 355-1463
Organization SubpartNo
Authorized OfficialGail Lee HartmannTreasurer · (636) 733-7000
Enumeration DateAugust 11, 2014
✔ NPI 1497164834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MO · 041853
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
4505 PARKER RD, Black Jack, MO 63033
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Other Names 1

Doing Business AsGarden Villas North

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 26D2071712

Garden Villas North Assisted Living · Florissant, MO
Active · expires Jan 16, 2028
CLIA Number26D2071712
Laboratory TypeAssisted Living Facility
Certificate Effective DateJanuary 17, 2026
Certificate Expiration DateJanuary 16, 2028
Laboratory DirectorBabu Dandamudi
Laboratory Phone(314) 355-6100
Laboratory LocationGarden Villas North Assisted Living4505 Parker Rd, Florissant, MO 63033
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Garden Villas North, LLC's NPI number?

The NPI number for Garden Villas North, LLC is 1497164834. It was assigned to this organization in the NPPES registry on August 11, 2014. The provider is doing business as Garden Villas North.

Where is Garden Villas North, LLC located?

Garden Villas North, LLC is located at 4505 Parker Rd, Black Jack, MO 63033. The listed phone number is (314) 355-6100.

What is Garden Villas North, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Garden Villas North, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2071712) is associated with this NPI, valid through January 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Garden Villas North, LLC was last updated on August 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.