Organization
MISSOURI RESIDENTIAL CARE LLC
Active
Other names
Chateau Ann Marie
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER M. VANCIL (OWNER/ADMINISTRATOR)
(314) 449-1497
Entity
Organization
Contact information
Practice address
7700 MINNESOTA AVE, SAINT LOUIS, MO 63111-3336
(314) 449-1497
(314) 449-1614
Mailing address
7700 MINNESOTA AVE, SAINT LOUIS, MO 63111-3336
(314) 449-1497
(314) 449-1614
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
032772
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266859602
—
MO
01
—
M266859602
MO HEALTHNET
MO
Enumeration date
06/13/2008
Last updated
01/11/2018
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