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General NPI Number Information
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NPI Number | 1447537071
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC CARE AND RESEARCH CENTER INC
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 4132 KEATON CROSSING BLVD STE 201
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City | O FALLON
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State | MO
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Zip | 63368-8222
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Country | US
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Telephone | 636-244-3589
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Fax | 636-244-3594
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Provider Business Mailing Address
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Address Line | 4132 KEATON CROSSING BLVD STE 201
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City | O FALLON
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State | MO
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Zip | 63368-8222
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Country | US
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Telephone | 636-244-3589
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Fax | 636-244-3594
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN P CANALE
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Credential | MD
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Telephone | 636-244-3589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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