Organization
ST. LOUIS ARC
Active
Organization
ST. LOUIS ARC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN TISONE CFO (VICE PRESIDENT OPERATIONS CFO)
(314) 817-2207
Entity
Organization
Contact information
Practice address
1816 LACKLAND HILL PKWY STE 200, SAINT LOUIS, MO 63146-3507
(314) 569-0778
Mailing address
1816 LACKLAND HILL PKWY STE 200, SAINT LOUIS, MO 63146-3507
(314) 569-0778
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
852945708
—
MO
Enumeration date
04/03/2007
Last updated
11/29/2007
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