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NPI 1780763284

NPI 1780763284 : SSM HEALTH CARE ST. LOUIS : SAINT LOUIS, MO

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General NPI Number Information
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    NPI Number           |    1780763284
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    Entity Type          |    Organization 
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    Legal Business Name  |    SSM HEALTH CARE ST. LOUIS 
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Dates
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    Enumeration Date     |    11/03/2006
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    Last Update Date     |    11/27/2023
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Provider Practice Location Address
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    Address Line         |    6420 CLAYTON RD 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63117-1811
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    Country              |    US
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    Telephone            |    314-768-8000
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    Fax                  |    314-768-8011
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Provider Business Mailing Address
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    Address Line         |    6420 CLAYTON RD 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63117-1811
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    Country              |    US
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    Telephone            |    314-768-8000
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    Fax                  |    314-768-8011
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    MR. TRAVIS  CAPERS 
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    Credential           |    
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    Telephone            |    314-768-8052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    273R00000X
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    Taxonomy Name        |    Psychiatric Hospital Unit
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    License Number       |    383-13
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    License Number State |    MO
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