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Organization

CBASS-AXIS INC.

Active
Parent organization
CBASS-AXIS INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CBASS-AXIS INC.
Authorized official
MR. HAROLD MANGRUM (CEO)
(314) 295-9862
Entity
Organization

Contact information

Practice address
4535 LINDELL BLVD, # 310, SAINT LOUIS, MO 63108-2030
(314) 295-9862
Mailing address
4535 LINDELL BLVD, #310, SAINT LOUIS, MO 63108-2030
(314) 295-9862

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
101YP1600X
Pastoral Counselor
101YP2500X
Professional Counselor
103T00000X
Psychologist
171M00000X
Case Manager/Care Coordinator
251B00000X
Case Management Agency
252Y00000X
Early Intervention Provider Agency

Other

Enumeration date
01/21/2014
Last updated
03/17/2017
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