# MARYGROVE

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

## Provider details

- **NPI number:** 1952385585
- **Authorized official:** HELEN NEGRI LCSW (CEO)
- **Authorized official phone:** (314) 830-6201

## Contact information

- **Practice address:** 2705 MULLANPHY LN, FLORISSANT, MO 63031-3727
- **Practice address phone:** (314) 830-6201
- **Practice address fax:** (314) 830-6258
- **Mailing address:** 2705 MULLANPHY LN, FLORISSANT, MO 63031-3727
- **Mailing address phone:** (314) 830-6201
- **Mailing address fax:** (314) 830-6258

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | MO | Yes |

## Other

- **Enumeration date:** 12/06/2005
- **Last updated:** 07/21/2022