Healthcare Provider Details

I. General information

NPI: 1972106581
Provider Name (Legal Business Name): CASTLEWOOD TREATMENT CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 SPRING VALLEY RD
PACIFIC MO
63069-2723
US

IV. Provider business mailing address

1855 BOWLES AVE STE 210
FENTON MO
63026-1900
US

V. Phone/Fax

Practice location:
  • Phone: 636-779-1444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: HEATHER WILHELM
Title or Position: DIRECTOR OF CLIENT FINANCE
Credential:
Phone: 314-471-5350