COVENANT HOUSE MISSOURI (NPI# 1467781393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467781393 |
| Entity Type | Organization |
| Organization Name | COVENANT HOUSE MISSOURI |
| Practice Address |
2727 N Kingshighway Blvd Saint Louis MO 63113-1006 |
| Mailing Address |
2727 N. Kingshighway Boulevard St. Louis MO 63113 |
| Practice Telephone | 3144507667 |
| Practice Fax Number | 3144540005 |
| Mailing Telephone | 3144507667 |
| Mailing Fax Number | 3144540005 |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2009-12-24 |
| Authorized Official Name | MS. KRISTINA R KERSTING (CLINICAL COORDINATOR) |
| Authorized Official Telephone | 3144507667 |
| Authorized Official Credential | MALPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 2004036418 | MO | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 499019503 | 05 | |
| MO | NPI | 1457324485 | 01 |
| Street Address |
2727 N KINGSHIGHWAY BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63113-1006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457324485 | Kristina R Kersting | Counselor | 2727 N Kingshighway Blvd, Saint Louis, MO 63113-1006 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487139937 | Kaniya Kashell Smotherman | In Home Supportive Care | 3834a Cotebrilliante Ave., St Louis, Mo, MO 63113 | 2018-10-01 |
| 1124530977 | Unique Diamonds, LLC | Counselor | 4068 Maffitt, St. Louis, MO 63113 | 2017-11-02 |
| 1821507831 | Another Day At Life LLC | Home Health | 1515 N Warson Rd Suite 103, St. Louis, MO 63113 | 2017-09-21 |
| 1124570999 | Carestl Health | Clinic/Center | 4248 Cottage Ave, Saint Louis, MO 63113 | 2016-10-27 |
| 1164801528 | Brittany Ashcraft | Social Worker | 1220 N Linbergh Blvd, Apt A, Saint Louis, MO 63113 | 2015-05-19 |
| 1538596465 | Enduring Heart In Home Care Services | Home Health | 1012 Sarah, Saint Louis, MO 63113 | 2013-10-10 |
| 1386989127 | Friends of African Amer. Family Service Center | Community/Behavioral Health | 1033 Whittier Avenue, Room 118, Saint Louis, MO 63113 | 2012-12-05 |
| 1598018202 | Shelia Latrese Bradford | Home Health | 3637 North Market St, St. Louis, MO 63113 | 2012-10-18 |
| 1043587736 | Angels Adult Day Care | Custodial Care Facility | 5021 Northland Avenue, Saint Louis, MO 63113 | 2011-11-23 |
| 1154575033 | Debra Lynn Miller | Occupational Therapist | 3645 Cook Ave., St. Louis, MO 63113 | 2008-11-05 |
| Find all providers in zip 63113 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659558054 | General Assembly of The Christian Church Disciples of Christ St. Louis | Residential Treatment Facility, Emotionally Disturbed Children | 3033 N Euclid Ave, Saint Louis, MO 63115-1632 | 2008-01-28 |
| 1093881252 | Good Shepherd Children and Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 1340 Partridge Ave, Saint Louis, MO 63130-1943 | 2006-11-28 |
| 1790879617 | Presbyterian Children's Services | Residential Treatment Facility, Emotionally Disturbed Children | 1353 N Warson Rd, Saint Louis, MO 63132-1807 | 2006-10-03 |
| 1679578413 | Child Center of Our Lady | Residential Treatment Facility, Emotionally Disturbed Children | 7900 Natural Bridge Rd, Saint Louis, MO 63121-4628 | 2005-06-17 |
| 1578098489 | St. Vincent Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 7401 Florissant Rd, Saint Louis, MO 63121-4835 | 2017-04-28 |
| 1225388465 | Great Circle- Edgewood Children's Center | Residential Treatment Facility, Emotionally Disturbed Children | 330 N Gore Ave, Saint Louis, MO 63119-1600 | 2012-09-14 |
| 1801109343 | Children's Foundation of Mid America | Residential Treatment Facility, Emotionally Disturbed Children | 1353 N Warson Rd, Saint Louis, MO 63132-1807 | 2010-07-26 |
| 1780846451 | Susie Dietz Mcgaughey | Residential Treatment Facility, Emotionally Disturbed Children | 330 N Gore Ave, Saint Louis, MO 63119-1600 | 2008-06-25 |
| 1104093681 | German St. Vincent Orphan Association | Residential Treatment Facility, Emotionally Disturbed Children | 7401 Florissant Rd, Saint Louis, MO 63121-4835 | 2008-05-13 |
| 1356538243 | Beth A Reese | Residential Treatment Facility, Emotionally Disturbed Children | 8240 Saint Charles Rock Rd, Saint Louis, MO 63114-4508 | 2007-09-25 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63113 |
Please comment or provide details below to improve the information on COVENANT HOUSE MISSOURI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.