Healthcare Provider Details

I. General information

NPI: 1427983493
Provider Name (Legal Business Name): ONE BEHAVIORAL OF MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 CEDAR PLAZA PKWY STE 380
SAINT LOUIS MO
63128-3859
US

IV. Provider business mailing address

5000 CEDAR PLAZA PKWY STE 380
SAINT LOUIS MO
63128-3859
US

V. Phone/Fax

Practice location:
  • Phone: 314-200-1366
  • Fax: 314-282-7708
Mailing address:
  • Phone: 314-200-1366
  • Fax: 314-282-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADAM SKY
Title or Position: CMO
Credential: MD
Phone: 314-200-1366