Organization
ST LOUIS ORGANIZATION FOR CHANGING MEN
Active
Other names
d/b/a RAVEN
Organization subpart
No
Provider details
NPI number
Authorized official
BARB HILTZ MSW (EXECUTIVE DIRECTOR)
(314) 645-2075
Entity
Organization
Contact information
Practice address
4515 OLIVE ST, SUITE 200, SAINT LOUIS, MO 63108-1814
(314) 645-2075
Mailing address
4515 OLIVE ST, SUITE 200, SAINT LOUIS, MO 63108-1814
(314) 645-2075
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
TAX ID#: 12463256
MO
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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