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Organization
COMPREHENSIVE INDEPENDENT GOALS INC ST LOUIS
Active
Organization
COMPREHENSIVE INDEPENDENT GOALS INC ST LOUIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONNIE MAX MCGOWAN (PRESIDENT & CHIEF FINANCIAL OFFICER)
(866) 926-5192
Entity
Organization
Contact information
Practice address
40 N KINGSHIGHWAY BLVD STE 6, SAINT LOUIS, MO 63108-1370
(866) 926-5192
(866) 926-5191
Mailing address
PO BOX 66037, BATON ROUGE, LA 70896-6037
(866) 926-5192
(866) 926-5191
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1157384
—
LA
05
—
1157392
—
LA
05
—
1173835
—
LA
05
—
1642649
—
LA
Enumeration date
06/25/2010
Last updated
06/25/2010
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