Organization Name: | RIDE ON ST LOUIS, INC. |
NPI Number: | 1275877805 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARITA A WASSMAN (PROGRAM DIRECTOR) |
Mailing Address: | 6008 Windsor Harbor Ln Imperial |
State: | MO US |
Postal Code: | 63052 |
Phone Number: | 6364643408 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2012 |
NPI Last Update Date: | 11/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320700000X |
License Number: | 01694 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |