MEDICARE: NORTHLIGHT DEVELOPMENT LP

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	171W00000X	Contractor	26655	MO

General Provider Information

NPI Number	:	1427422336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHLIGHT DEVELOPMENT LP

Provider Business Mailing Address
First Line	:	3414 HAWTHORNE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-1623
Country	:	US
Telephone Number	:	314-773-4074
Fax Number	:

Provider Business Practice Location Address
First Line	:	3414 HAWTHORNE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-1623
Country	:	US
Telephone Number	:	314-773-4074
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KENNETH R SMITH JR.
Credential	:	MD
Telephone Number	:	314-773-4074

Provider Enumeration Date	:	11/17/2015
Last Update Date	:	11/17/2015

Similar Medicare Providers

1508859851 — MS. KANETTE TURNER RN
Practice Location Address:

5471 MARTIN LUTHER KING BLVD
SAINT LOUIS, MO
63140-1623

Practice Phone: 314-367-5820
Practice Fax: 314-367-7010

1619121514 — M.A. C. UNLIMITED, LLC
Practice Location Address:

5017 TENNESSEE AVE
SAINT LOUIS, MO
63111-1623

Practice Phone: 314-766-7198
Practice Fax:

1326327024 — GOD'S GRACE L.L.C.
Practice Location Address:

6708 ROBBINS AVE
SAINT LOUIS, MO
63133-1623

Practice Phone: 314-803-8364
Practice Fax:

1659748754 — MR. STEPHEN BENINTENDI LPC, SRT, EMDR
Practice Location Address:

1623 E SAINT LOUIS ST
SPRINGFIELD, MO
65802-3129

Practice Phone: 417-833-9999
Practice Fax:

1033666417 — DR. CHRISTINE CLARK PSY.D., L.P.
Practice Location Address:

7601 WAYZATA BLVD
SAINT LOUIS PARK, MN
55426-1623

Practice Phone: 612-223-8899
Practice Fax:

1366954299 — A DIMENSION OF IN HOME CARE
Practice Location Address:

1911 WASHINGTON AVE
SAINT LOUIS, MO
63103-1623

Practice Phone: 314-322-9429
Practice Fax:

Directions to “NORTHLIGHT DEVELOPMENT LP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.