Organization
MAGDALA FOUNDATION
Active
Parent organization
MAGDALA FOUNDATION
Other names
Augusta
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAGDALA FOUNDATION
Authorized official
MR. DAVID JOHN MEYER (EXECUTIVE DIRECTOR)
(314) 652-6004
Entity
Organization
Contact information
Practice address
7400 AUGUSTA AVE, SAINT LOUIS, MO 63121-4802
(314) 652-6004
(314) 652-8351
Mailing address
4158 LINDELL BLVD, SAINT LOUIS, MO 63108-2914
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2452 10039
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112182704
—
MO
Enumeration date
05/23/2008
Last updated
05/23/2008
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