N/a
NPI #1861782898 in Saint Louis, Missouri
Provider Information
- NPI Number
- 1861782898
- Entity Type
- Organization
- Organization Name
- N/a
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Apr 11, 2011
- Last Updated
- Apr 11, 2011
Practice Location
- Address
- 1318 PENNSYLVANIA AVE
- City
- Saint Louis
- State
- Missouri
- ZIP Code
- 63133-1036
- Phone
- (314) 401-1466
Authorized Official
- Name
- MS. GLORIA JEAN PATRICK
- Title
- HOME AID
- Phone
- (314) 401-1466
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Residential Treatment Facility, Physical Disabilities |
| Psychiatric Residential Treatment Facility |
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