Organization
FAMILIES 1ST OF DESOTO, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN MARIE O'ROURKE ANP (OWNER/ANP)
(636) 337-7800
Entity
Organization
Contact information
Practice address
127 W PRATT ST, DE SOTO, MO 63020-2107
(636) 337-7800
(636) 586-2276
Mailing address
127 W PRATT ST, DE SOTO, MO 63020-2107
(636) 337-7800
(636) 586-2276
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538591227
—
MO
Enumeration date
08/09/2018
Last updated
08/09/2018
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