Organization
BJC BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MARTIN-DAVIS (PRESIDENT)
(314) 206-3712
Entity
Organization
Contact information
Practice address
1085 MAPLE ST, FARMINGTON, MO 63640-1955
(573) 756-5353
Mailing address
3309 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1101
(314) 206-3700
(314) 206-3881
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
267-7258
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154902001
—
MO
05
—
154902019
—
MO
01
—
7107617
MO DEPT OF MENTAL HEALTH
—
05
—
876175803
—
MO
05
—
876175811
—
MO
Enumeration date
08/11/2006
Last updated
04/01/2024
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