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General NPI Number Information
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NPI Number | 1417004623
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Entity Type | Organization
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Legal Business Name | ADAPT OF MISSOURI, LLC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 2301 HAMPTON AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-2908
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Country | US
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Telephone | 888-657-3201
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Fax | 314-781-3295
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Provider Business Mailing Address
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Address Line | 2301 HAMPTON AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-2908
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Country | US
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Telephone | 888-657-3201
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Fax | 314-781-3295
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | TERESA PORTER
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Credential |
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Telephone | 636-466-6452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health 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 | 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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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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