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General NPI Number Information
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NPI Number | 1952288458
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Entity Type | Organization
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Legal Business Name | TWELVE TRIBES OF YISRAEL
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 654 N 38TH ST
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City | EAST SAINT LOUIS
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State | IL
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Zip | 62205-2106
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Country | US
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Telephone | 618-494-4701
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 STANWOOD DR
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City | SAINT LOUIS
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State | MO
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Zip | 63121-1423
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DRIVER
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Name | KEVIN JONES
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Credential |
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Telephone | 314-201-0959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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