Organization
BETTY JEAN KERR PEOPLE'S HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE BUTLER (PRESIDENT & CEO)
(314) 367-7848
Entity
Organization
Contact information
Practice address
11642 W FLORISSANT AVE, FLORISSANT, MO 63033-6723
(314) 838-8220
(314) 838-4007
Mailing address
11642 W FLORISSANT AVE, FLORISSANT, MO 63033-6723
(314) 838-8220
(314) 838-4007
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518095470
—
MO
05
—
500543343
—
MO
Enumeration date
03/01/2007
Last updated
05/13/2014
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