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General NPI Number Information
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NPI Number | 1790954410
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Entity Type | Organization
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Legal Business Name | CASTLEWOOD TREATMENT CENTER LLC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 1855 BOWLES AVE, SUITE 210
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City | FENTON
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State | MO
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Zip | 63026
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Country | US
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Telephone | 636-779-1430
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Fax | 314-686-4920
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Provider Business Mailing Address
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Address Line | 1855 BOWLES AVE STE 210
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City | FENTON
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State | MO
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Zip | 63026-1900
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Country | US
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Telephone | 314-222-7441
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLIENT ACCOUNTS
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Name | HEATHER WILHELM
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Credential |
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Telephone | 314-222-7441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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