Marygrove

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

MARYGROVE

Practice address

2705 Mullanphy LN
Florissant, MO 63031-3727

Phone

(314) 830-6201

Fax

(314) 830-6258

NPI assigned

Dec 6, 2005

Organization subpart

No

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

Authorized official

Name

Helen Negri, LCSW

Title

Ceo

Phone

(314) 830-6201

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Catholic Comprehensive Services for Children Child Center-Marygrove3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Catholic Comprehensive Services for Children, Child Center-Marygrove

  dba Child Center-Marygrove

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Florissant, MO
  • NPI 1487718854
  NPD tax ID
• Child Center - Marygrove

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Florissant, MO
  • NPI 1104979053
  NPD tax ID

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1952385585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 MULLANPHY LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630313727",
            "telephone_number": "314-830-6201",
            "fax_number": "314-830-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 MULLANPHY LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630313727",
            "telephone_number": "314-830-6201",
            "fax_number": "314-830-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYGROVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NEGRI",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-830-6201",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline E. Marstall, PA-C
• Trevor Martin
• Kasey Martindale
• Lauren Michelle Martinez, MSW, LCSW, RPT
• Tara L. Maryas, C.O.A.
• Mike Massay
• Michael M Matar, MD
• Matthew Wade Wicht (Connexions)
• Carmen Christine Matthews
• Crystal T Matthews, CNA

• Emotionally Disturbed Childrens' Residential Treatment Facility in Florissant, MO
• Providers in Florissant, MO by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.