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General NPI Number Information
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NPI Number | 1144156514
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Entity Type | Organization
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Legal Business Name | STEADFAST PROMISE HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 2129 ROSEBUD AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63121-5631
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Country | US
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Telephone | 557-218-3977
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Fax |
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Provider Business Mailing Address
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Address Line | 6182 BAY TREE DR
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City | FLORISSANT
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State | MO
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Zip | 63033-4743
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Country | US
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Telephone | 557-218-3977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIARA JOHNSON-SMITH
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Credential |
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Telephone | 557-218-3977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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