Organization
CRIDER HEALTH CENTER,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA HEEBNER (ASSOCIATE CEO, COO)
(636) 332-8306
Entity
Organization
Contact information
Practice address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385-4836
(636) 332-6000
(363) 332-3045
Mailing address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385-4836
(636) 332-6000
(363) 332-3045
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504605312
—
MO
Enumeration date
11/25/2009
Last updated
11/04/2011
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