Organization
BLACK ALCOHOL/DRUG SERVICE INFORMATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YULONDA SINGLETON-CARTER MS (EXECUTIVE ASSISTANT)
(314) 621-9009
Entity
Organization
Contact information
Practice address
3026 LOCUST ST, SAINT LOUIS, MO 63103-1329
(314) 621-9009
(314) 621-1071
Mailing address
3026 LOCUST ST, SAINT LOUIS, MO 63103-1329
(314) 621-9009
(314) 621-1071
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
8043
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346372380
EXISTING NPI
MO
05
—
866202708
—
MO
Enumeration date
05/17/2016
Last updated
05/17/2016
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