Organization
ST. PATRICK CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAUREEN THERESE HENTZ MA, LPC (CLINICAL SUPERVISOR)
(314) 802-1958
Entity
Organization
Contact information
Practice address
800 N TUCKER BLVD, SAINT LOUIS, MO 63101-1000
(314) 802-1958
(314) 802-1980
Mailing address
800 N TUCKER BLVD, SAINT LOUIS, MO 63101-1000
(314) 802-1958
(314) 802-1980
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YM0800X
—
MO
Enumeration date
10/14/2016
Last updated
10/14/2016
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