Marymount Manor LLC
Marymount Manor LLC is a healthcare organization registered as Skilled Nursing Facility in Eureka, MO, holding Type 2 (organization) NPI 1457412587 since 2006. The authorized official on file is Charles Riley, Memeber.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1457412587 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Marymount Manor LLC |
| Practice address | 313 AUGUSTINE RD, Eureka, MO, 63025 |
| Phone | 6369386770 |
| Fax | 6369383742 |
| Enumeration date | 2006-12-13 |
| Last updated in NPPES | 2009-12-01 |
Authorized official
| Name | Charles Riley |
|---|---|
| Title | Memeber |
| Phone | 6363492311 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101491009 | Medicaid | MO | — |
Copy-ready billing details
Provider: Marymount Manor LLC NPI: 1457412587 Taxonomy: 314000000X (Skilled Nursing Facility) Address: 313 AUGUSTINE RD, Eureka, MO, 63025
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1629052915 | Mid America Healthcare Lp | Organization | Assisted Living Facility | Eureka, MO |
| 1982689485 | Mid America Healthcare Lp | Organization | Skilled Nursing Facility | Eureka, MO |
| 1598828774 | Marymount Manor LLC | Organization | Assisted Living Facility | Eureka, MO |
Verify this record
Cross-check NPI 1457412587 against the authoritative CMS record: view Marymount Manor LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Marymount Manor LLC located?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2009-12-01.