Organization · Type 2 NPI

State of Missouri

Psychiatric Residential Treatment Facility · St. Louis, MO

NPI number 1487721379 Active

Practice location

1901 Pennsylvania Ave
St. Louis, MO 63133-1325

Call (314) 512-7609 Map

Fax (314) 512-7812

Mailing address

1706 E Elm St
Jefferson City, MO 65101-4130

Specialties and licenses

Taxonomy	Code	License
Psychiatric Residential Treatment Facility Primary	323P00000X	None listed

Psychiatric Residential Treatment Facility: A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital car…

14 other providers at this address

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NPI record

NPI: 1487721379
Entity type: Organization (Type 2)
Issued: Nov 29, 2006
Last updated: Oct 27, 2020
Status: Active
Subpart: Yes of State of Missouri

Other names

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Hawthorn Children's Psychiatric Hosptial · doing business as
Hawthorn Children's Psychiatric Hosptial · doing business as

Authorized official

Molly Jane Boeckmann
Director of Administrative Services
(573) 751-4055

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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 1487721379

State of Missouri's National Provider Identifier is 1487721379, issued on Nov 29, 2006. The primary taxonomy on file is Psychiatric Residential Treatment Facility (323P00000X), and the practice location is in St. Louis, MO. The record was last updated on Oct 27, 2020.