Organization
CHILD CENTER OF OUR LADY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM BAUSCH MSW (EXECUTIVE DIRECTOR)
(314) 383-0200
Entity
Organization
Contact information
Practice address
7900 NATURAL BRIDGE RD, SAINT LOUIS, MO 63121-4628
(314) 383-0200
(314) 383-6334
Mailing address
7900 NATURAL BRIDGE RD, SAINT LOUIS, MO 63121-4628
(314) 383-0200
(314) 383-6334
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/17/2005
Last updated
08/22/2020
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