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Organization

BJC BEHAVIORAL HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK STANSBERRY (EXECUTIVE DIRECTOR)
(314) 206-3714
Entity
Organization

Contact information

Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(573) 756-5353
(573) 756-4557
Mailing address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
(314) 206-3881

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
267-7258
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7107617
DEPT OF MENTAL HEALTH
MO
05
876175811
MO
Enumeration date
03/09/2007
Last updated
04/01/2024
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