Healthcare Provider Details

I. General information

NPI: 1871451443
Provider Name (Legal Business Name): ZANDER'S AUTISM COMMUNITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 01/13/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5844 DEGIVERVILLE AVE
ST. LOUIS MO
63112
US

IV. Provider business mailing address

5844 DEGIVERVILLE AVE
ST. LOUIS MO
63112
US

V. Phone/Fax

Practice location:
  • Phone: 314-885-9975
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. KENYA SIMPSON
Title or Position: CEO
Credential:
Phone: 314-885-9975