Organization
MSA ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES B DAVIS FACHE, MBA, MHSA (VP MEDICAL STAFF SERVICES)
(618) 257-6302
Entity
Organization
Contact information
Practice address
4600 MEMORIAL DR, STE 325, BELLEVILLE, IL 62226-5368
(618) 236-6501
(618) 236-6551
Mailing address
PO BOX 24035, BELLEVILLE, IL 62223-9035
(618) 222-9999
(618) 222-9337
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/28/2010
Last updated
07/28/2010
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