Organization
CANOPY PACIFIC BH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN ZELCER (PRESIDENT)
(732) 994-8956
Entity
Organization
Contact information
Practice address
2510 SPRING VALLEY RD, PACIFIC, MO 63069-2723
(732) 994-8956
Mailing address
9433 OLIVE BLVD # 100, SAINT LOUIS, MO 63132-3132
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/09/2026
Last updated
07/09/2026
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