MEDICARE: CARESTL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)		MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376685529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARESTL HEALTH

Provider Business Mailing Address
First Line	:	2425 WHITTIER ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-2950
Country	:	US
Telephone Number	:	314-367-5820
Fax Number	:	314-367-7010

Provider Business Practice Location Address
First Line	:	2425 WHITTIER ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-2950
Country	:	US
Telephone Number	:	314-371-3100
Fax Number	:	314-289-8718

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ANGELA R CLABON
Credential	:	MBA
Telephone Number	:	314-367-5820

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	09/26/2018

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Practice Location Address:

2425 WHITTIER ST
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63113-2950

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1356860159 — A PLUS HEALTH AND WELLNESS CENTER INC.
Practice Location Address:

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1922417310 — DANIEL KENT JENSEN DPT
Practice Location Address:

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Directions to “CARESTL HEALTH ” Practice Location

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