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NPI Code Detail

MEDICARE: HOUSE OF JOY

MEDICARE: HOUSE OF JOY
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1861125130
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSE OF JOY
Provider Business Mailing Address
First Line : 734 KINGSLAND AVE APT 3S
Second Line :
City : UNIVERSITY CITY
State : MO
Zip : 63130-3108
Country : US
Telephone Number : 314-221-9318
Fax Number :
Provider Business Practice Location Address
First Line : 1047 S BIG BEND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63117-1605
Country : US
Telephone Number : 314-329-5886
Fax Number :
Authorized Official
Title or Position : CEO
Name : JOY CISKOWSKI
Credential : MA, LPC
Telephone Number : 314-329-5886
Provider Enumeration Date : 07/05/2022
Last Update Date : 07/05/2022

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Directions to “HOUSE OF JOY ” Practice Location

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