MEDICARE: THE BRAIN INJURY FOUNDATION OF ST. LOUIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	251V00000X	Voluntary or Charitable Agency
3	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1184266314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BRAIN INJURY FOUNDATION OF ST. LOUIS

Provider Business Mailing Address
First Line	:	7850 MANCHESTER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-2710
Country	:	US
Telephone Number	:	314-645-7230
Fax Number	:	844-527-4893

Provider Business Practice Location Address
First Line	:	7850 MANCHESTER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-2710
Country	:	US
Telephone Number	:	314-645-7230
Fax Number	:	844-527-4893

Authorized Official
Title or Position	:	DIRECTOR OF CLIENT SERVICES
Name	:	MS. SARAH ANN DAVIS
Credential	:	CBIST
Telephone Number	:	314-645-7230

Provider Enumeration Date	:	10/09/2019
Last Update Date	:	10/09/2019

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Directions to “THE BRAIN INJURY FOUNDATION OF ST. LOUIS ” Practice Location

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