# PSYCHIATRIC CENTER OF CREVE COEUR,LTD.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Psychiatric Center Ltd.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881750214
- **Authorized official:** DR. MICHAEL ROMAN BANTON M.D. (PRESIDENT)
- **Authorized official phone:** (314) 692-7886

## Contact information

- **Practice address:** 13100 MANCHESTER RD STE 150, SAINT LOUIS, MO 63131-1743
- **Practice address phone:** (314) 692-7886
- **Practice address fax:** (314) 692-7929
- **Mailing address:** 13100 MANCHESTER RD STE 150, SAINT LOUIS, MO 63131-1743
- **Mailing address phone:** (314) 692-7886
- **Mailing address fax:** (314) 692-7929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 09076046 | MO | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 06/29/2022