Organization
AGM IOP/PHP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANCO SICURO M.D. (OWNER)
(314) 222-0602
Entity
Organization
Contact information
Practice address
10199 WOODFIELD LN, OLIVETTE, MO 63132-2922
(314) 282-2517
(314) 845-2798
Mailing address
10199 WOODFIELD LN, OLIVETTE, MO 63132-2922
(314) 222-0602
(314) 675-6681
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
LC001426559
MO
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
LC001426559
MO
Other
Enumeration date
02/04/2015
Last updated
04/08/2019
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