Active NPI
St. Louis Arc
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Hazelwood, MO
National Provider Identifier
1669658910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- License
- 103091
- Legal business name
- ST. LOUIS ARC
- Practice address
- 714 Carriage LN
Hazelwood, MO 63042-3452 - Phone
- (314) 817-2207
- NPI assigned
- Jan 17, 2008
- Last updated
- Jun 12, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kathleen Anne Tisone
- Title
- VP Operations/Cfo
- Phone
- (314) 817-2207
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 103091 | MO | Primary |
Addresses
Primary practice location
714 Carriage LN
Hazelwood, MO 63042-3452
Mailing address
1177 N Warson Rd
Saint Louis, MO 63132-1810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 852998301 | Medicaid | MO |
National Provider Directory
National Provider Directory- Tax ID family
- St Louis Arc
Other organizations with this tax ID 25
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1841460623
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1083890347
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1104002450
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1124204474
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1134305485
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1144406497
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1154507408
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1194846220
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1215113568
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1295984995
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1457537714
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- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Saint Louis, MO
- NPI 1467638726
Practitioners & affiliated clinicians
Practitioners 42
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Speech-Language Pathologist
- Saint Louis, MO
- NPI 1255446803
-
- Behavior Analyst
- Saint Louis, MO
- NPI 1780055954
-
- Speech-Language Pathologist
- Saint Louis, MO
- NPI 1306331434
-
- Pediatric Occupational Therapist
- Saint Louis, MO
- NPI 1942457403
-
- Speech-Language Pathologist
- Saint Louis, MO
- NPI 1821428202
-
- Pediatric Physical Therapist
- Saint Louis, MO
- NPI 1821189184
-
- Behavior Analyst
- Saint Louis, MO
- NPI 1699119875
-
- Pediatric Occupational Therapist
- Saint Louis, MO
- NPI 1063849958
-
- Pediatric Occupational Therapist
- Saint Louis, MO
- NPI 1124427497
-
- Speech-Language Pathologist
- Saint Louis, MO
- NPI 1770921561
-
- Pediatric Occupational Therapist
- St. Lois, MO
- NPI 1972649242
-
- Behavior Analyst
- Saint Louis, MO
- NPI 1821654856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1339459200000",
"number": "1669658910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 N WARSON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631321810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 CARRIAGE LN",
"city": "HAZELWOOD",
"state": "MO",
"postal_code": "630423452",
"telephone_number": "314-817-2207"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST. LOUIS ARC",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-17",
"last_updated": "2012-06-12",
"status": "A",
"authorized_official_last_name": "TISONE",
"authorized_official_first_name": "KATHLEEN",
"authorized_official_middle_name": "ANNE",
"authorized_official_title_or_position": "VP OPERATIONS/CFO",
"authorized_official_telephone_number": "314-817-2207",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "MO",
"license": "103091",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "852998301",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hazelwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.