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General NPI Number Information
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NPI Number | 1346903911
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Entity Type | Organization
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Legal Business Name | EQUILIBRIUM MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/20/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 5700 MEXICO RD STE 8
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City | SAINT PETERS
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State | MO
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Zip | 63376-1667
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Country | US
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Telephone | 636-477-6464
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Fax | 636-410-9291
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Provider Business Mailing Address
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Address Line | 521 KENT DR
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City | WENTZVILLE
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State | MO
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Zip | 63385-1316
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Country | US
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Telephone | 314-707-5956
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | BRITTANIA RENE PHILLIPS
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Credential | DNP, APRN, PMHNP-BC
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Telephone | 314-707-5956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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