Organization · NPI-2

1st Choice Organization House Of 1st Choice

Clinic/Center, Mental Health (Including Community Mental Health Center) · Florissant, MO

NPI number1760079545
StatusActive
Last updated in NPPESDec 28, 2020

Details

NPI
1760079545
Entity type
Organization (NPI-2)
Legal business name
1st Choice Organization House Of 1st Choice
Organization subpart
No
Enumeration date
Dec 28, 2020
Certification date
Dec 28, 2020
Last updated
Dec 28, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

3837 Vaile Ave Ste D
Florissant, MO 63034-2210

Phone 314-942-1127 · Fax 314-279-1006

Mailing address

3837 Vaile Ave Ste D
Florissant, MO 63034-2210

Phone 314-942-1127 · Fax 314-279-1006

Authorized official

Latonya Baker
Owner
3149421127

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