Organization
12 AND BEYOND MO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER GIFFORD (CHIEF EXECUTIVE OFFICER)
(602) 816-9421
Entity
Organization
Contact information
Practice address
4700 HAMPTON AVE, SAINT LOUIS, MO 63109-2718
(602) 816-9421
(954) 301-8110
Mailing address
4700 HAMPTON AVE, SAINT LOUIS, MO 63109-2718
(602) 816-9421
(954) 301-8110
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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