=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598074601
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AFTERWARDS WE CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2010
-----------------------------------------------------
Last Update Date | 10/07/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4046 HUMPHREY ST
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63116-3823
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-256-9575
-----------------------------------------------------
Fax | 314-255-2283
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 110 LINDALE AVE
-----------------------------------------------------
City | WATERLOO
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50703-5516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-256-9575
-----------------------------------------------------
Fax | 314-255-2283
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JOE FREDRICK ROBINSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 314-256-9575
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 2005028641
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------