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Organization
EQUILIBRIUM HOMES OF ST. LOUIS LLC
Active
Organization
EQUILIBRIUM HOMES OF ST. LOUIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IESHA POWELL (OWNER / PROGRAM DIRECTOR)
(314) 715-4666
Entity
Organization
Contact information
Practice address
3054 SIR CHRISTOPHER LN, FLORISSANT, MO 63033-3114
(314) 659-6167
Mailing address
3054 SIR CHRISTOPHER LN, FLORISSANT, MO 63033-3114
(314) 659-6167
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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