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General NPI Number Information
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NPI Number | 1275759144
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Entity Type | Organization
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Legal Business Name | JEWISH COMMUNITY CENTER
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 2 MILLSTONE CAMPUS DR
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City | SAINT LOUIS
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State | MO
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Zip | 63146-5776
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Country | US
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Telephone | 314-432-5700
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Fax | 314-872-7189
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Provider Business Mailing Address
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Address Line | 2 MILLSTONE CAMPUS DR
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City | SAINT LOUIS
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State | MO
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Zip | 63146-5776
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Country | US
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Telephone | 314-432-5700
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Fax | 314-872-7189
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Authorized Official
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Title or Position | COO
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Name | NICOLE L HAWKINS
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Credential |
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Telephone | 314-442-3148
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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 | 1036
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 584
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License Number State | MO
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