Healthcare Provider Details

I. General information

NPI: 1669779294
Provider Name (Legal Business Name): BEHAVIOR SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 02/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 PORTWEST CT
SAINT CHARLES MO
63303-5985
US

IV. Provider business mailing address

321 COPPER TREE CT
O FALLON MO
63368-6339
US

V. Phone/Fax

Practice location:
  • Phone: 636-265-0407
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ANGIE PEELER
Title or Position: VICE PRESIDENT
Credential:
Phone: 636-265-0407