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Organization

KIRWOOD MEDICATION ASSISTED TREATMENTS

Active
Parent organization
DR GARY HAMMEN MD PHD LLC
Other names
Kirkwood Medication Assisted Treatments
Organization subpart
Yes

Provider details

NPI number
Legal business name
DR GARY HAMMEN MD PHD LLC
Authorized official
DR. GARY HAMMEN MD PHD (MEMBER)
(314) 644-8310
Entity
Organization

Contact information

Practice address
111 PROSPECT AVE STE 201, KIRKWOOD, MO 63122-6052
(314) 644-8310
(314) 293-6749
Mailing address
111 PROSPECT AVE STE 201, KIRKWOOD, MO 63122-6052
(314) 644-8310
(314) 293-6749

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary

Other

Enumeration date
10/17/2019
Last updated
05/25/2020
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