Healthcare Provider Details

I. General information

NPI: 1518887785
Provider Name (Legal Business Name): ST LOUIS MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 BIRKHEAD RD
WINFIELD MO
63389-3247
US

IV. Provider business mailing address

350 BIRKHEAD RD
WINFIELD MO
63389-3247
US

V. Phone/Fax

Practice location:
  • Phone: 314-271-1612
  • Fax:
Mailing address:
  • Phone: 314-271-1612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: NICHOALS CIES
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 314-271-1612