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Organization

CRIDER HEALTH CENTER,INC

Active
Parent organization
CRIDER HEALTH CENTER,INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CRIDER HEALTH CENTER,INC.
Authorized official
LAURA HEEBNER (SEN VP COO)
(636) 332-8000
Entity
Organization

Contact information

Practice address
416 MARKET ST, WASHINGTON, MO 63090-2610
(636) 239-8397
Mailing address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385-4836
(636) 332-8000

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
26-1012
MO
05
504605338
MO
Enumeration date
09/12/2007
Last updated
05/08/2008
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