Organization
PROCARE ISL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIGRE SMITH (OWNER)
(314) 757-0188
Entity
Organization
Contact information
Practice address
2040 WOODSON RD STE 203B, OVERLAND, MO 63114-5606
(314) 755-1444
(314) 755-1446
Mailing address
2040 WOODSON RD STE 203B, OVERLAND, MO 63114-5606
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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