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General NPI Number Information
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NPI Number | 1043813785
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Entity Type | Organization
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Legal Business Name | COMMUNITY RESPONSE
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 5261 DELMAR BLVD STE 202
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1013
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Country | US
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Telephone | 314-685-8834
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Fax | 314-685-8847
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Provider Business Mailing Address
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Address Line | PO BOX 28961
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City | SAINT LOUIS
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State | MO
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Zip | 63132-0961
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Country | US
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Telephone | 314-402-2126
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Fax | 314-685-8847
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BARBARA MCGHEE
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Credential | MSW, LCSW, MPH
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Telephone | 314-402-2126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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