Healthcare Provider Details

I. General information

NPI: 1285574756
Provider Name (Legal Business Name): MO EVEREST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S 4TH ST STE 518
SAINT LOUIS MO
63102-1800
US

IV. Provider business mailing address

100 S 4TH ST STE 550
SAINT LOUIS MO
63102-1897
US

V. Phone/Fax

Practice location:
  • Phone: 314-668-2866
  • Fax:
Mailing address:
  • Phone: 314-668-2866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: YISROEL DOVID SKAIST
Title or Position: CEO
Credential:
Phone: 314-668-2866