Healthcare Provider Details

I. General information

NPI: 1477959641
Provider Name (Legal Business Name): FRIENDS - A MEETING PLACE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2014
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 N COMPTON AVE
SAINT LOUIS MO
63103-1225
US

IV. Provider business mailing address

716 N COMPTON AVE
SAINT LOUIS MO
63103-1225
US

V. Phone/Fax

Practice location:
  • Phone: 314-535-5800
  • Fax: 314-535-5801
Mailing address:
  • Phone: 314-535-5800
  • Fax: 314-535-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1207
License Number StateMO

VIII. Authorized Official

Name: JEAN MCCLENDON
Title or Position: PRESIDENT
Credential:
Phone: 314-535-5800