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AUTUMN RIDGE
NPI 1801039524
Assisted Living Facility in Herculaneum, MO

Active since April 10, 2009
300 AUTUMN RIDGE DRIVE, HERCULANEUM, MO 63048(636) 931-8400(636) 933-3975 Get Directions Write a Review

NPPES record last updated: July 28, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Autumn Ridge NPPES

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

AUTUMN RIDGE (NPI 1801039524) is a healthcare organization registered as an assisted living facility in Herculaneum, Missouri and active in the NPI registry since April 2009. The organization lists Benjamin Klein, Manager, as its authorized official.

NPPES Registry Identity

NPI1801039524
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePHAR, LLC
Location Address300 AUTUMN RIDGE DRIVEHerculaneum, MO 63048-1505
Mailing Address7444 Long AveSkokie, IL 60077-3214 · (847) 329-4100 · Fax (847) 329-7652
Phone(636) 931-8400
Fax(636) 933-3975
Organization SubpartNo
Authorized OfficialBenjamin KleinManager · (847) 329-4100
Enumeration DateApril 10, 2009
Last NPPES UpdateJuly 28, 2009
✔ NPI 1801039524 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 · 037148
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.
300 AUTUMN RIDGE DRIVE, Herculaneum, MO 63048
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Other Names 1

Other NameAutumn Ridge

Other Identifiers 1

MedicaidM266744705MO

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 26D0889301

Autumn Ridge Residential Care · Herculaneum, MO
Expired · Jul 24, 2026
CLIA Number26D0889301
Laboratory TypeAssisted Living Facility
Certificate Effective DateJuly 25, 2024
Certificate Expiration DateJuly 24, 2026
Laboratory DirectorSusan Koch
Laboratory Phone(636) 931-8400
Laboratory LocationAutumn Ridge Residential Care300 Autumn Ridge Drive, Herculaneum, MO 63048
CLIA data matches this NPI record on: Address 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 Phar, LLC's NPI number?

The NPI number for Phar, LLC is 1801039524. It was assigned to this organization in the NPPES registry on April 10, 2009. The provider is also known as Autumn Ridge.

Where is Phar, LLC located?

Phar, LLC is located at 300 Autumn Ridge Drive, Herculaneum, MO 63048. The listed phone number is (636) 931-8400.

What is Phar, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Phar, LLC was last updated on July 28, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.