| Psychiatric Center Ltd. | |
|
13100 Manchester Rd Ste 150 Saint Louis MO 63131-1743 | |
| (314) 692-7886 | |
| (314) 692-7929 |
| Full Name | Psychiatric Center Ltd. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 13100 Manchester Rd Ste 150, Saint Louis, Missouri |
| Authorized Official Name and Position | Michael Roman Banton (PRESIDENT) |
| Authorized Official Contact | 3146927886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Center Ltd. 13100 Manchester Rd Ste 150 Saint Louis MO 63131-1743 Ph: (314) 692-7886 | Psychiatric Center Ltd. 13100 Manchester Rd Ste 150 Saint Louis MO 63131-1743 Ph: (314) 692-7886 |
| NPI Number | 1881750214 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 06/29/2022 |
| Certification Date | 06/29/2022 |
| Medicare PECOS PAC ID | 4981796992 |
|---|---|
| Medicare Enrollment ID | O20070822001107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881750214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 09076046 (Missouri) | Primary |
| Provider Name | Marta H Da Silva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831176353 PECOS PAC ID: 4082681820 Enrollment ID: I20040913000403 |
| Provider Name | Michael R Banton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619984523 PECOS PAC ID: 4981796588 Enrollment ID: I20100824000118 |
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