1386989127 NPI number — FRIENDS OF AFRICAN AMER. FAMILY SERVICE CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386989127 NPI number — FRIENDS OF AFRICAN AMER. FAMILY SERVICE CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRIENDS OF AFRICAN AMER. FAMILY SERVICE CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386989127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 52355
Provider Second Line Business Mailing Address:
1033 WHITTIER AVE. ROOM 118
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63136-8355
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-867-6470
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1033 WHITTIER AVENUE
Provider Second Line Business Practice Location Address:
ROOM 118
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-867-6470
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/05/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
JEAN
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
314-867-6470

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 104100000X . This is a "SOCIAL WORKER" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1O41CO700X . This is a "SOCIAL WORKER CLINICAL" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com