Organization · Type 2 NPI

Independence Center

Mental Illness Community Based Residential Treatment Facility · St. Louis, MO

NPI number 1780720680 Active

Practice location

19 N Newstead Ave
St. Louis, MO 63108-2260

Call (314) 286-4510 Map

Fax (314) 286-4565

Mailing address

4245 Forest Park Ave
St. Louis, MO 63108-2810

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000X033539 (MO)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1780720680

Independence Center's National Provider Identifier is 1780720680, issued on Jan 29, 2007. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in St. Louis, MO. The record was last updated on Jun 27, 2022.