Equilibrium Homes of St. Louis LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

EQUILIBRIUM HOMES OF ST. LOUIS LLC

Practice address

3054 Sir Christopher LN
Florissant, MO 63033-3114

Phone

(314) 659-6167

NPI assigned

Feb 9, 2017

Organization subpart

No

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

Authorized official

Name

Iesha Powell

Title

Owner / Program Director

Phone

(314) 715-4666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1699213603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3054 SIR CHRISTOPHER LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630333114",
            "telephone_number": "314-659-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3054 SIR CHRISTOPHER LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630333114",
            "telephone_number": "314-659-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIUM HOMES OF ST. LOUIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "IESHA",
        "authorized_official_title_or_position": "OWNER / PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "314-715-4666"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Florissant, MO
• Providers in Florissant, MO by specialty
• Intellectual Disabilities Intermediate Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.