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General NPI Number Information
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NPI Number | 1134455561
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Entity Type | Organization
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Legal Business Name | BJC BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 343 S KIRKWOOD RD
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City | SAINT LOUIS
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State | MO
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Zip | 63122-6195
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Country | US
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Telephone | 314-206-3447
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Fax |
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Provider Business Mailing Address
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Address Line | 343 S KIRKWOOD RD
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City | SAINT LOUIS
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State | MO
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Zip | 63122-6195
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Country | US
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Telephone | 314-206-3447
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Fax |
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR
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Name | KATHY MORGAN
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Credential | MSW
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Telephone | 314-206-3496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | MO
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