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General NPI Number Information
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NPI Number | 1093883928
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Entity Type | Organization
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Legal Business Name | HOUSE OF PAIS, INC.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 724 N. UNION BLVD STE 309
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1038
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Country | US
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Telephone | 314-361-4720
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Fax |
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Provider Business Mailing Address
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Address Line | 724 UNION BLVD STE 309
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1038
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Country | US
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Telephone | 314-361-4720
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. STANFORD SCOTT COOPER SR.
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Credential |
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Telephone | 314-361-4720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 813
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License Number State | MO
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