# RIDE ON ST LOUIS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275877805
- **Authorized official:** MRS. MARITA A WASSMAN (PROGRAM DIRECTOR)
- **Authorized official phone:** (636) 464-3408

## Contact information

- **Practice address:** 6008 WINDSOR HARBOR LN, IMPERIAL, MO 63052
- **Practice address phone:** (636) 464-3408
- **Mailing address:** PO BOX 94, KIMMSWICK, MO 63053-0094
- **Mailing address phone:** (636) 464-3408

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | 01694 | MO | Yes |

## Other

- **Enumeration date:** 11/20/2012
- **Last updated:** 11/20/2012