NPIMap

Organization Active NPI

Catholic Comprehensive Services for Children, Child Center-Marygrove

Doing business as Child Center-Marygrove

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Florissant, MO
National Provider Identifier
1487718854
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
000045669 Issued in MO
Legal business name
CATHOLIC COMPREHENSIVE SERVICES FOR CHILDREN, CHILD CENTER-MARYGROVE
Doing business as
Child Center-Marygrove
Practice address
2705 Mullanphy LN
Florissant, MO 63031-3727
Phone
(314) 837-1702
Fax
(314) 830-6263
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Dr. Michael P Meehan, PH.D.
Title
Chief Executive Officer
Phone
(314) 830-6222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 000045669 MO Primary

Addresses

Primary practice location

2705 Mullanphy LN
Florissant, MO 63031-3727

Mailing address

2705 Mullanphy LN
Florissant, MO 63031-3727
Phone (314) 837-1702

Other names 1

  • Child Center-Marygrove Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Catholic Comprehensive Services for Children Child Center-Marygrove3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1487718854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 MULLANPHY LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630313727",
            "telephone_number": "314-837-1702",
            "fax_number": "314-830-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 MULLANPHY LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630313727",
            "telephone_number": "314-837-1702",
            "fax_number": "314-830-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC COMPREHENSIVE SERVICES FOR CHILDREN, CHILD CENTER-MARYGROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "MEEHAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "314-830-6222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MO",
            "license": "000045669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Center-Marygrove",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Child Center-Marygrove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.