Procare Isl, LLC

NPI #1598323115 in Overland, Missouri

Provider Information

NPI Number: 1598323115
Entity Type: Organization
Organization Name: Procare Isl, LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 29, 2019
Last Updated: May 29, 2019

Practice Location

Address: 2040 WOODSON RD STE 203B
City: Overland
State: Missouri
ZIP Code: 63114-5606
Phone: (314) 755-1444

Authorized Official

Name: TIGRE SMITH
Title: OWNER
Phone: (314) 757-0188

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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