Organization
EDGEWOOD CHILDREN'S HOM'E
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOANNE P HERZBERG MSA (THERAPIST)
(314) 968-2060
Entity
Organization
Contact information
Practice address
330 N GORE AVE, WEBSTER GROVES, MO 63119-1600
(314) 968-2060
Mailing address
330 N GORE, EDGEWOOD CHILDREN'S HOME, WEBSTER GROVES, MO 63119
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
000266
MO
251S00000X
Community/Behavioral Health Agency
000266
MO
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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