NPIMap

Organization Active NPI

N/a

  • Psychiatric Residential Treatment Facility
  • Saint Louis, MO
National Provider Identifier
1861782898
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
07397218 Issued in MO
Legal business name
N/A
Doing business as
Gloria Patrick
Practice address
1318 Pennsylvania Ave
Saint Louis, MO 63133-1036
Phone
(314) 401-1466
NPI assigned
Apr 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Authorized official

Name
Ms. Gloria Jean Patrick
Title
Home Aid
Phone
(314) 401-1466

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 07397218 MO
Physical Disabilities Residential Treatment Facility 320700000X 07397218 MO
Psychiatric Residential Treatment Facility 323P00000X 07397218 MO Primary

Addresses

Primary practice location

1318 Pennsylvania Ave
Saint Louis, MO 63133-1036

Mailing address

1318 Pennsylvania Ave
Pagedale, MO 63133-1036
Phone (314) 401-1466

Other names 1

  • Gloria Patrick Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1861782898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 PENNSYLVANIA AVE",
            "city": "PAGEDALE",
            "state": "MO",
            "postal_code": "631331036",
            "telephone_number": "314-401-1466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 PENNSYLVANIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631331036",
            "telephone_number": "314-401-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N/A",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "HOME AID",
        "authorized_official_telephone_number": "314-401-1466",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MO",
            "license": "07397218",
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "MO",
            "license": "07397218",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "MO",
            "license": "07397218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gloria Patrick",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 11, 2011; 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.