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General NPI Number Information
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NPI Number | 1700929627
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Entity Type | Organization
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Legal Business Name | EASTER SEALS MIDWEST
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 8621 BRENNER AVENUE
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City | OVERLAND
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State | MO
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Zip | 63114
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Country | US
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Telephone | 314-394-7100
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Fax | 314-394-4007
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Provider Business Mailing Address
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Address Line | 13545 BARRETT PARKWAY DRIVE SUITE 300
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City | BALLWIN
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State | MO
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Zip | 63021
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Country | US
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Telephone | 314-394-7100
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Fax | 314-394-4007
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Authorized Official
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Title or Position | VICE PRESIDENT, CFO
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Name | MR. JOHN W. ADKINS
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Credential |
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Telephone | 314-394-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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