Organization
CALISTA E. MELKERSMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CALISTA ELIZABETH MELKERSMAN (OWNER)
(314) 440-1352
Entity
Organization
Contact information
Practice address
4635 FRANKFORT AVE, SAINT LOUIS, MO 63123-5832
(314) 440-1352
Mailing address
4635 FRANKFORT AVE, SAINT LOUIS, MO 63123-5832
(314) 440-1352
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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