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General NPI Number Information
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NPI Number | 1174719728
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Entity Type | Organization
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Legal Business Name | TOWER VILLAGE FUND, INC.
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 4518 BLAIR AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63107-1404
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Country | US
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Telephone | 314-534-4000
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Fax | 314-534-2709
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Provider Business Mailing Address
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Address Line | 4518 BLAIR AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63107-1404
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Country | US
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Telephone | 314-534-4000
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Fax | 314-534-2709
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Authorized Official
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Title or Position | CEO
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Name | CAROL A WEIR
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Credential | LCSW, LNHA
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Telephone | 314-534-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 0006460
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License Number State | MO
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