Healthcare Provider Details

I. General information

NPI: 1184560526
Provider Name (Legal Business Name): KOREDE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4317 FOREST PARK AVE
SAINT LOUIS MO
63108-2820
US

IV. Provider business mailing address

4317 FOREST PARK AVE
SAINT LOUIS MO
63108-2820
US

V. Phone/Fax

Practice location:
  • Phone: 314-266-8205
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: SARAH BETH MATT
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 314-266-8205