Healthcare Provider Details

I. General information

NPI: 1720920515
Provider Name (Legal Business Name): GREENBRIAR GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 BRIDGECREST XING
SAINT CHARLES MO
63303-4814
US

IV. Provider business mailing address

1925 BRIDGECREST XING
SAINT CHARLES MO
63303-4814
US

V. Phone/Fax

Practice location:
  • Phone: 314-312-3759
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAMON ARMSTRONG
Title or Position: NPI ADMIN/COMPLIANCE COORDINATOR
Credential:
Phone: 314-312-3759