Carestl Health

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

CARESTL HEALTH

Practice address

7047 Emma Ave
Jennings, MO 63136

Phone

(314) 653-8070

Fax

(314) 653-8075

NPI assigned

Nov 28, 2016

Organization subpart

No

Name

Mrs. Angela Renee Archibaldclabon

Title

Chief Executive Officer

Phone

(314) 367-5820

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 6, 2018.

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1912440876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 DR MARTIN LUTHER KING DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7047 EMMA AVE",
            "city": "JENNINGS",
            "state": "MO",
            "postal_code": "63136",
            "telephone_number": "314-653-8070",
            "fax_number": "314-653-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESTL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "ARCHIBALDCLABON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "314-367-5820",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Athletico LTD
• William Bishop, DPT
• Linda Doretha Burch
• Care Plus Home Health LLC
• Caregivers United LLC
• John-Michael Charles, PHARM.D.
• Sharde Clay, PHARMD
• CVJ Homes LLC
• Kathleen Marie Dahm, OTRL CHT
• Robyn Drake, NP

• All providers in Jennings, MO
• Federally Qualified Health Center (FQHC) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.