NPIMap

Organization Active NPI

Preferred Family Healthcare, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1770628885
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
6300-9238 Issued in MO
Legal business name
PREFERRED FAMILY HEALTHCARE, INC.
Practice address
7020 Chippewa St
Saint Louis, MO 63119-5602
Phone
(314) 835-0226
Fax
(314) 644-0461
NPI assigned
Feb 20, 2007
Last updated
Jul 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Mark Conover
Title
Chief Revenue Officer
Phone
(573) 603-1460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 6300-9238 MO Primary

Addresses

Primary practice location

7020 Chippewa St
Saint Louis, MO 63119-5602

Mailing address

1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 224-1210

Other practice location 1

3800 S Broadway
Saint Louis, MO 63118-4608
Phone (314) 772-2205

Other identifiers 1

IdentifierTypeStateIssuer
866204506MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051019000599 MO Part B Supplier - Clinic/Group Practice 0244256246 Receives reassigned benefits from 143 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Louis, MO; Madison, MO; Saint Charles, MO; Paris, MO; Monroe City, MO; Moberly, MO; Montgomery City, MO; Saint Peters, MO…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1770628885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD SOUTH RIVER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034120",
            "telephone_number": "636-224-1210",
            "fax_number": "636-246-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195602",
            "telephone_number": "314-835-0226",
            "fax_number": "314-644-0461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631184608",
            "country_code": "US",
            "telephone_number": "314-772-2205",
            "fax_number": "314-772-9264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREFERRED FAMILY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "CONOVER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "573-603-1460"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MO",
            "license": "6300-9238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "866204506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.