Organization
CARESTL HEALTH
Active
Other names
St Louis Comprehensive II
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA RENEE CLABON (CEO)
(314) 367-5820
Entity
Organization
Contact information
Practice address
4411 N NEWSTEAD AVE, ST LOUIS, MO 63115-2534
(314) 381-9990
(314) 381-8993
Mailing address
5471 DR MARTIN LUTHER KING DR, ST LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
520
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500622923
—
MO
Enumeration date
05/07/2007
Last updated
02/06/2019
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