Organization Name: | EASTER SEALS MIDWEST |
NPI Number: | 1649301789 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN W. ADKINS (VICE PRESIDENT, CFO) |
Mailing Address: | 13545 Barrett Parkway Drive Suite 300 Ballwin |
State: | MO US |
Postal Code: | 63021 |
Phone Number: | 3143947100 |
Fax Number: | 3143944007 |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 02/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 01/06/2011 |
NPI Reactivation Date: | 02/03/2015 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |