The Community Counseling & Housing Services
Organization Active NPI Assisted Living Facility (Mental Illness) · Jennings, MO
NPI 1477052058 · NPPES record last updated Feb 8, 2018
Key facts
- NPI
- 1477052058
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility (Mental Illness) 3104A0625X
- Legal business name
- THE COMMUNITY COUNSELING & HOUSING SERVICES
- Practice address
- 2407 Petrova Ave
Jennings, MO 63136-3903 - Phone
- (314) 580-3029
- NPI assigned
- Feb 8, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Marvin Shelton, ED.S, ED.D, RADC-P
- Title
- Ceo
- Phone
- (314) 580-3029
Corporate family (same tax ID) 7
National Provider Directory
- Tax ID family
- The Community Counseling Housing Services
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Case Management Agency | 251B00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| VA Clinic/Center | 261QV0200X | |||
| Assisted Living Facility (Mental Illness) | 3104A0625X | Yes | ||
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | |||
| Psychiatric Residential Treatment Facility | 323P00000X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | |||
| Managed Care Organization Pharmacy | 3336M0003X |
Addresses
Primary practice location
2407 Petrova Ave
Jennings, MO 63136-3903
Mailing address
4166 Lindell Blvd Apt 1B
Saint Louis, MO 63108-2923
Phone (314) 580-3029
Other names
- THE PETROVA HOUSE
Other providers in Jennings, MO
- St. Elizabeth Adult Day Care Center, Inc.
- Chandler Austin Stephens
- Strategic Home Health Care
- Strategic Home Health Care - in Home Services
- Avoree Switzer
- Total Renal Care Inc
- Trinity Counseling Unified LLC
- Valerie Wade
- Walgreen Co
- Christian Watts
All providers in Jennings, MO · Assisted Living Facility (Mental Illness) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.