Healthcare Provider Details

I. General information

NPI: 1467590125
Provider Name (Legal Business Name): HOPE CLINICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11971 WESTLINE INDUSTRIAL DR STE 103
SAINT LOUIS MO
63146-3231
US

IV. Provider business mailing address

11971 WESTLINE INDUSTRIAL DR STE 103
SAINT LOUIS MO
63146-3231
US

V. Phone/Fax

Practice location:
  • Phone: 636-733-3330
  • Fax: 636-733-3332
Mailing address:
  • Phone: 636-733-3330
  • Fax: 636-733-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CLINT W PAUL
Title or Position: PRESIDENT / CEO
Credential:
Phone: 217-585-5134