Healthcare Provider Details

I. General information

NPI: 1578015822
Provider Name (Legal Business Name): A PLUS WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3312 BROWN RD
SAINT LOUIS MO
63114-4328
US

IV. Provider business mailing address

3312 BROWN RD
SAINT LOUIS MO
63114-4328
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-0073
  • Fax: 314-567-1940
Mailing address:
  • Phone: 314-567-0073
  • Fax: 314-567-1940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number01013276
License Number StateMO

VIII. Authorized Official

Name: CHARLES L HILTON
Title or Position: PRESIDENT
Credential:
Phone: 314-495-6412