Organization
STORGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEJA RENEE SCOTT (CEO)
(314) 449-9420
Entity
Organization
Contact information
Practice address
7114 VERNON AVE, UNIVERSITY CITY, MO 63130-2301
(314) 475-4147
(314) 216-3710
Mailing address
PO BOX 142860, SAINT LOUIS, MO 63114-0860
(314) 475-4147
(314) 282-0688
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/17/2017
Last updated
11/20/2017
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