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General NPI Number Information
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NPI Number | 1306020797
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Entity Type | Organization
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Legal Business Name | COMMUNITY BEHAVIOR HEALTH
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1027 S VANDEVENTER AVE FL 2
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City | SAINT LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone | 314-282-0804
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 WASHINGTON
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City | ST LOUIS
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State | MO
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Zip | 63108
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Country | US
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Telephone | 314-367-0302
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Fax | 314-367-0301
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. NAIM MUHAMMAD
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Credential | M.ED, BA, RASAC
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Telephone | 314-556-4443
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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 | MO
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