MEDICARE: CHILD CENTER OF OUR LADY

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
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1679578413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILD CENTER OF OUR LADY

Provider Business Mailing Address
First Line	:	7900 NATURAL BRIDGE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-4628
Country	:	US
Telephone Number	:	314-383-0200
Fax Number	:	314-383-6334

Provider Business Practice Location Address
First Line	:	7900 NATURAL BRIDGE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-4628
Country	:	US
Telephone Number	:	314-383-0200
Fax Number	:	314-383-6334

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. JIM BAUSCH
Credential	:	MSW
Telephone Number	:	314-383-0200

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1306019914 — STEPHAN BRENNER MD
Practice Location Address:

4628 MCPHERSON AVE
SAINT LOUIS, MO
63108-1937

Practice Phone: 312-208-7304
Practice Fax:

1396989430 — JOSEPH GOODMAN RN
Practice Location Address:

3641 S SPRING AVE
SAINT LOUIS, MO
63116-4628

Practice Phone: 314-456-9524
Practice Fax:

1568778447 — MS. ALISON GRACE RICO LCSW
Practice Location Address:

6816 WASHINGTON AVE
SAINT LOUIS, MO
63130-4628

Practice Phone: 314-222-4858
Practice Fax:

1114297363 — STEPHANIE C KORPAL M.ED.
Practice Location Address:

6816 WASHINGTON AVE
SAINT LOUIS, MO
63130-4628

Practice Phone: 314-222-4872
Practice Fax:

1093794299 — MR. FRANK R BACQUE M.D.
Practice Location Address:

602 SAINT LANDRY ST
LAFAYETTE, LA
70506-4628

Practice Phone: 337-235-1200
Practice Fax: 337-237-1021

1992108591 — KAREN DENEHY MS, LMHC
Practice Location Address:

5030 ARAGON WAY S
SAINT PETERSBURG, FL
33705-4628

Practice Phone: 727-873-9311
Practice Fax:

Directions to “CHILD CENTER OF OUR LADY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.