Phillip Brown
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Hazelwood, MO. Individual provider (NPI-1).
NPI number1164045068
StatusActive
Last updated in NPPESMay 26, 2020
Details
- NPI
- 1164045068
- Entity type
- Individual (NPI-1)
- Name
- Phillip Brown
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 26, 2020
- Certification date
- May 26, 2020
- Last updated
- May 26, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
| 251C00000X | Day Training, Developmentally Disabled Services | – | – |
Practice location
4954 Hurstborough CtHazelwood, MO 63042-1592
Phone 314-566-8301
Mailing address
4954 Hurstborough CtHazelwood, MO 63042-1592
Phone 314-566-8301
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All 7 Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility providers in Hazelwood · All 615 providers in Hazelwood
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