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300 1st Capitol Dr Saint Charles MO 63301-2844 | |
| (636) 947-5000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 300 1st Capitol Dr, Saint Charles, Missouri |
| Authorized Official Name and Position | Lisle Wescott (PRESIDENT) |
| Authorized Official Contact | 6369475076 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
300 1st Capitol Dr Saint Charles MO 63301-2844 Ph: (636) 947-5000 | 300 1st Capitol Dr Saint Charles MO 63301-2844 Ph: (636) 947-5000 |
| NPI Number | 1396814083 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396814083 | NPI | - | NPPES |
| 430652671403 | Medicaid | IL | |
| 430652671003 | Medicaid | IL | |
| 540418100 | Medicaid | MO | |
| 010418101 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 494-0 (Missouri) | Primary |
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