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13545 Barrett Pkwy Drive Suite 300 Ballwin MO 63021 | |
| (314) 394-7100 | |
| (314) 394-4007 |
| Full Name | |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 13545 Barrett Pkwy Drive, Ballwin, Missouri |
| Authorized Official Name and Position | John W. Adkins (VICE PRESIDENT, CFO) |
| Authorized Official Contact | 3143947100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13545 Barrett Parkway Drive Suite 300 Ballwin MO 63021 Ph: (314) 394-7100 | 13545 Barrett Pkwy Drive Suite 300 Ballwin MO 63021 Ph: (314) 394-7100 |
| NPI Number | 1871625582 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 02/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871625582 | NPI | - | NPPES |
| 852794502 | Medicaid | MO |
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