Organization
SUPPORT INNOVATIONS PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY KLEINLEIN (PRESIDENT)
(314) 205-0588
Entity
Organization
Contact information
Practice address
1811 DUNN RD, FLORISSANT, MO 63033-6116
(314) 839-4458
(314) 839-1159
Mailing address
13422 CLAYTON RD, SUITE 214, SAINT LOUIS, MO 63131-1008
(314) 205-0588
(314) 205-0586
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3209
—
MO
Enumeration date
01/06/2012
Last updated
01/31/2012
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