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General NPI Number Information
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NPI Number | 1336771047
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Entity Type | Organization
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Legal Business Name | COMMUNITY BEHAVIOR HEALTH II
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 11897 BENHAM RD
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City | SAINT LOUIS
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State | MO
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Zip | 63138-1326
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Country | US
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Telephone | 314-277-1547
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Fax |
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Provider Business Mailing Address
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Address Line | 11897 BENHAM RD
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City | SAINT LOUIS
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State | MO
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Zip | 63138-1326
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Country | US
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Telephone | 314-277-1547
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TRINA MUHAMMAD
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Credential |
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Telephone | 314-277-1547
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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 | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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