Organization
GOOD SHEPHERD SCHOOL FOR CHILDREN
Active
Other names
Good Shepherd Pediatric Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH A. ROSE M.S.W. LCSW (EXECUTIVE DIRECTOR)
(314) 469-0606
Entity
Organization
Contact information
Practice address
1170 TIMBER RUN DR, SAINT LOUIS, MO 63146-4482
(314) 469-0606
(314) 469-3294
Mailing address
1170 TIMBER RUN DR, SAINT LOUIS, MO 63146-4482
(314) 469-0606
(314) 469-3294
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131233
BLUE CROSS BLUE SHIELD
MO
01
—
39420
GROUP HEALTH PLAN
MO
05
—
507419703
—
MO
Enumeration date
01/29/2007
Last updated
10/06/2010
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