Organization
MY PLACE TOO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY L CASEY LPN, LNHA (ADMINISTRATOR)
(636) 526-7871
Entity
Organization
Contact information
Practice address
1107 CLARKE ST, DE SOTO, MO 63020-2709
(636) 586-7871
Mailing address
23 N 6TH ST, FESTUS, MO 63028-1301
(636) 933-1793
(636) 933-6446
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PENDING
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037346
DEPT HEALTH & SENIOR SERVICES
MO
01
—
PENDING
DEPT OF MENTAL HEALTH
MO
Enumeration date
10/02/2009
Last updated
10/02/2009
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