Organization · Type 2 NPI

LDS Family Services

Mental Health Clinic/Center (Including Community Mental Health Center) · Bridgeton, MO

NPI number 1174625388 Active

Practice location

12843 Pennridge Dr
Bridgeton, MO 63044-1238

Fax (314) 344-0057

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	2002002940 (MO)

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

2 other providers at this address

Other mental health clinic/center (including community mental health center) providers in Bridgeton

Love's Basics LLCMental Health Clinic/Center (Including Community Mental Health Center) Bridgeton, MO NPI 1205501947

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NPI record

NPI: 1174625388
Entity type: Organization (Type 2)
Issued: Sep 1, 2006
Last updated: Jun 6, 2008
Status: Active
Subpart: Yes of LDS Family Services

Other names

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LDS Family Services Mo Bridgeton · doing business as

Authorized official

Mr. Paul R. Gale, LCSW
Agency Director
(816) 461-5512

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174625388

LDS Family Services's National Provider Identifier is 1174625388, issued on Sep 1, 2006. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Bridgeton, MO. The record was last updated on Jun 6, 2008.