institution
Independence Center
Mental Illness Community Based Residential Treatment Facility in Saint Louis, Missouri
NPI 1174669006

Independence Center is a Mental Illness Community Based Residential Treatment Facility based in Saint Louis, MO. Independence Center practices in Saint Louis, MO. The NPI Number for Independence Center is 1174669006 and holds a License No. 030777 (Missouri).

The current practice location address for Independence Center is 2443 Prouhet Ave, Saint Louis, MO and can be reached out via phone at 314-890-7100 and via fax at 314-890-7133.

Location: 2443 Prouhet Ave, Saint Louis, MO, 63132-2503
institution
Provider Profile Details
NPI Number
1174669006
Provider Name
Independence Center
Credential
Provider Entity Type
Organization
Address
2443 Prouhet Ave, Saint Louis, MO, 63132-2503
Phone Number
314-890-7100
Fax Number
314-890-7133
Provider Enumeration Date
01/29/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
267727600 05 MO
institution
Provider Business Practice Location Address Details
Address
2443 Prouhet Ave
City
State
Zip
63114-1946
Phone Number
314-890-7100
Fax Number
314-890-7133
person
Provider Business Mailing Address Details
Address
2443 Prouhet Ave
City
State
Zip
63114-1946
Phone Number
314-890-7100
Fax Number
314-890-7133
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
License No.
030777 (Missouri)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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