Organization
SEVI LIFE LLC
Active
Organization
SEVI LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIZELLE FLORES (CREDENTIALING MANAGER)
(860) 944-4766
Entity
Organization
Contact information
Practice address
300 SAINT PETERS CENTRE BLVD STE 250, SAINT PETERS, MO 63376-1662
(636) 245-5126
(636) 245-3235
Mailing address
300 SAINT PETERS CENTRE BLVD STE 250, SAINT PETERS, MO 63376-1662
(636) 245-5126
(636) 245-3235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
05/07/2024
Last updated
03/06/2025
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