Healthcare Provider Details
I. General information
NPI: 1528204203
Provider Name (Legal Business Name): NATIONAL INSTITUTE OF DIVINE SCIENCE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/30/2008
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14508 TRAMORE DR 8
CHESTERFIELD MO
63017-8141
US
IV. Provider business mailing address
14508 TRAMORE DR 8
CHESTERFIELD MO
63017-8141
US
V. Phone/Fax
- Phone: 213-814-2440
- Fax:
- Phone: 213-814-2440
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282J00000X |
| Taxonomy | Religious Nonmedical Health Care Institution |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 311Z00000X |
| Taxonomy | Custodial Care Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TANYA
FIELD
MEYER
Title or Position: DIRECTOR
Credential: PH.D., C.S.
Phone: 213-814-2440