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General NPI Number Information
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NPI Number | 1003290719
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Entity Type | Organization
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Legal Business Name | EXPRESS CARE SOLUTIONS, LLC
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 3641 OAKDALE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63121-5437
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Country | US
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Telephone | 314-727-0453
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Fax | 314-727-6067
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Provider Business Mailing Address
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Address Line | 3641 OAKDALE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63121-5437
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Country | US
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Telephone | 314-727-0453
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Fax | 314-727-6067
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. VIVIAN J MCCOLLUM
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Credential | PHD
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Telephone | 314-381-0155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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