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General NPI Number Information
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NPI Number | 1720958267
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Entity Type | Organization
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Legal Business Name | LEARN TO LIVE CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 910 W 14TH ST STE 150
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City | WASHINGTON
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State | MO
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Zip | 63090-7003
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Country | US
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Telephone | 636-432-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 910 W 14TH ST STE 150
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City | WASHINGTON
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State | MO
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Zip | 63090-7003
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Country | US
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Telephone | 636-432-1010
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Fax |
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Authorized Official
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Title or Position | FOUNDER, EXECUTIVE DIRECTOR
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Name | MATTHEW DALE BAUERSACHS
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Credential |
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Telephone | 314-376-0069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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