Organization
COMMUNITY AND LONG-TERM CARE PSYCHIATRY LLC
Active
Organization
COMMUNITY AND LONG-TERM CARE PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNEST ALEXANDER GRAYPEL M.D. (OWNER)
(314) 267-1075
Entity
Organization
Contact information
Practice address
10004 KENNERLY RD STE 362B, SAINT LOUIS, MO 63128-2178
(314) 525-5050
(314) 525-5072
Mailing address
10004 KENNERLY RD STE 362B, SAINT LOUIS, MO 63128-2178
(314) 525-5050
(314) 525-5072
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
2015002634
MO
2084P0800X
Psychiatry Physician
Primary
2015002634
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265723407
—
MO
01
—
156440095
MEDICARE
MO
01
—
P01585490
RR MEDICARE
MO
Enumeration date
05/10/2016
Last updated
01/17/2024
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