Ride on St Louis, Inc.

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

01694 Issued in MO

Legal business name

RIDE ON ST LOUIS, INC.

Practice address

6008 Windsor Harbor LN
Imperial, MO 63052

Phone

(636) 464-3408

NPI assigned

Nov 20, 2012

Last updated

Nov 20, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Marita A Wassman

Title

Program Director

Phone

(636) 464-3408

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1275877805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "KIMMSWICK",
            "state": "MO",
            "postal_code": "630530094",
            "telephone_number": "636-464-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6008 WINDSOR HARBOR LN",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "63052",
            "telephone_number": "636-464-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDE ON ST LOUIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "WASSMAN",
        "authorized_official_first_name": "MARITA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "636-464-3408",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "MO",
            "license": "01694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.