# SOLACE CARE NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Solace Care Network, Solace Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699504449
- **Authorized official:** MR. JEFFERY DAVIS DNP, FNP-BC, PMHNP (PRESIDENT)
- **Authorized official phone:** (314) 669-3075

## Contact information

- **Practice address:** 1046 GEYER GRV, KIRKWOOD, MO 63122-5884
- **Practice address phone:** (314) 669-3075
- **Practice address fax:** (314) 696-6886
- **Mailing address:** 1046 GEYER GRV, KIRKWOOD, MO 63122-5884
- **Mailing address phone:** (618) 409-6448

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | NULL | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2024
- **Last updated:** 11/03/2024