Organization
EASTER SEALS MIDWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN W. ADKINS (VICE PRESIDENT, CFO)
(314) 394-7100
Entity
Organization
Contact information
Practice address
918 BERNADETTE DRIVE, COLUMBIA, MO 65203
(314) 394-7100
(314) 394-4007
Mailing address
13545 BARRETT PARKWAY DRIVE, SUITE 300, BALLWIN, MO 63021
(314) 394-7100
(314) 394-4007
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
855404208
—
MO
Enumeration date
03/09/2007
Last updated
02/23/2015
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