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NPI Code Detail

MEDICARE: AUTONOMOUS CASE MANAGEMENT OF ST LOUIS

MEDICARE: AUTONOMOUS CASE MANAGEMENT OF ST LOUIS
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
1251B00000XCase Management Agency

General Provider Information

NPI Number : 1598999328
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTONOMOUS CASE MANAGEMENT OF ST LOUIS
Provider Business Mailing Address
First Line : 483 S KIRKWOOD RD # 221
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63122-6119
Country : US
Telephone Number : 314-293-0697
Fax Number :
Provider Business Practice Location Address
First Line : 11906 MANCHESTER RD STE 110
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63131-4504
Country : US
Telephone Number : 314-293-0697
Fax Number :
Authorized Official
Title or Position : EXEC DIRECTOR
Name : MS. JULIE HESS
Credential : RN
Telephone Number : 314-293-0697
Provider Enumeration Date : 05/07/2009
Last Update Date : 05/07/2009

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