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General NPI Number Information
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NPI Number | 1194146340
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Entity Type | Organization
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Legal Business Name | NATIONAL MENTOR SERVICES, LLC
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Dates
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Enumeration Date | 12/13/2013
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 9375 DIELMAN INDUSTRIAL DR
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City | OLIVETTE
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State | MO
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Zip | 63132-2212
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Country | US
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Telephone | 314-991-7944
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Fax | 314-991-6642
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Provider Business Mailing Address
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Address Line | 9375 DIELMAN INDUSTRIAL DR
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City | OLIVETTE
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State | MO
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Zip | 63132-2212
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Country | US
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Telephone | 314-991-7944
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Fax | 314-991-6642
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Authorized Official
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Title or Position | SR DIRECTOR OF OPERATIONS
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Name | RACHEL KRAMER
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Credential |
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Telephone | 314-991-7944
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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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