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NPI Code Detail

MEDICARE: REJUVENATING COMPREHENSIVE SERVICES

MEDICARE: REJUVENATING COMPREHENSIVE SERVICES
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
21041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11588009344OTHERMOPERSONAL NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437719879
Entity Type Code : Organization
Provider Name (Legal Business Name) : REJUVENATING COMPREHENSIVE SERVICES
Provider Business Mailing Address
First Line : 2100 E FAIR AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63107-1022
Country : US
Telephone Number : 314-504-4706
Fax Number : 314-659-8007
Provider Business Practice Location Address
First Line : 9231 W FLORISSANT AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-1422
Country : US
Telephone Number : 314-279-1444
Fax Number : 314-801-8178
Authorized Official
Title or Position : THERAPIST
Name : KEELY FINNEY
Credential : LCSW
Telephone Number : 314-504-4706
Provider Enumeration Date : 06/18/2019
Last Update Date : 05/14/2021

Similar Medicare Providers

1376503250 — DR. ADELUOLA G LIPEDE M.D.
Practice Location Address:
9231 W FLORISSANT AVE
SAINT LOUIS, MO
63136-1422
Practice Phone: 314-522-1888
Practice Fax: 314-522-9674
1679896716 — MARANATHA HEALTHCARE PC
Practice Location Address:
9231 W FLORISSANT AVE
SAINT LOUIS, MO
63136-1422
Practice Phone: 314-522-1888
Practice Fax: 314-522-9674
1427765585 — SANDRA BRYANT
Practice Location Address:
9231 W FLORISSANT AVE
SAINT LOUIS, MO
63136-1422
Practice Phone: 314-279-4444
Practice Fax:
1891561957 — DR. SAINT ISSAC RICE JR. EDD, MA
Practice Location Address:
9231 W FLORISSANT AVE
SAINT LOUIS, MO
63136-1422
Practice Phone: 314-279-1444
Practice Fax:
1578391199 — KIRAH L DICKERSON CHW-C
Practice Location Address:
9231 W FLORISSANT AVE
SAINT LOUIS, MO
63136-1422
Practice Phone: 314-504-4706
Practice Fax:
1225866858 — MPWER
Practice Location Address:
9231 W FLORISSANT AVE
SAINT LOUIS, MO
63136-1422
Practice Phone: 314-279-1444
Practice Fax: 314-735-1251

Directions to “REJUVENATING COMPREHENSIVE SERVICES ” Practice Location

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