THE PETROVA HOUSE – Assisted Living Facility (Mental Illness), NPI 1477052058

THE PETROVA HOUSE is a healthcare provider. based in Jennings, Missouri. specializing in Assisted Living Facility (Mental Illness). The NPI Number for THE PETROVA HOUSE is 1477052058

Main info

Organization
Name
THE PETROVA HOUSE
NPI
1477052058
Phone
(314) 580-3029
Address
2407 PETROVA AVE
Authorized Official
DR. MARVIN SHELTON CEO ED.S, ED.D, RADC-P
Enumeration Date
8 February 2018
Last Update Date
8 February 2018
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness80
Years active:8State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for THE PETROVA HOUSE

  • 2407, Petrova Avenue, Petrova Court, Jennings, Saint Louis County, Missouri, 63136, United States

    JENNINGS, MO 631363903

    Phone: (314) 580-3029

    Type: Location

  • 4166 LINDELL BLVD APT 1B

    SAINT LOUIS, MO 631082923

    Phone: (314) 580-3029

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63136)

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Reviews

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Frequently asked questions

Can I verify THE PETROVA HOUSE with an NPI only?
You can start verification with NPI 1477052058 for THE PETROVA HOUSE, then check state licensing separately.
Is THE PETROVA HOUSE listed as active for patients and plans?
The listing shows THE PETROVA HOUSE as active in the NPI system.
What taxonomy line describes THE PETROVA HOUSE?
For research purposes, treat THE PETROVA HOUSE as Assisted Living Facility (Mental Illness) in this dataset. Clinical services aligned with this taxonomy classification.
Where is THE PETROVA HOUSE based?
THE PETROVA HOUSE is tied to Jennings, Missouri in the data we show; additional addresses may exist on the full record.
Is the information about THE PETROVA HOUSE up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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