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Organization

MAGDALA FOUNDATION

Active
Parent organization
MAGDALA FOUNDATION
Other names
Canterbury
Organization subpart
Yes

Provider details

NPI number
Legal business name
MAGDALA FOUNDATION
Authorized official
MR. DAVID MEYER (EXECUTIVE DIRECTOR)
(314) 652-6004
Entity
Organization

Contact information

Practice address
3900 CANTERBURY DR, SAINT LOUIS, MO 63121-2500
(314) 652-6004
(314) 652-8351
Mailing address
4158 LINDELL BLVD, SAINT LOUIS, MO 63108-2914
(314) 652-6004
(314) 652-8351

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2452 10040
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
112182605
MO
Enumeration date
05/23/2008
Last updated
05/23/2008
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