1801164678 NPI number — BETTER LIVING PLUS LLC

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 1801164678 NPI number — BETTER LIVING PLUS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BETTER LIVING PLUS LLC
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:
1801164678
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 CRAIG ROAD
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
CREVE COUER
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-236-5001
Provider Business Mailing Address Fax Number:
314-569-0552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4351 DELMAR BLVD
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63108-2625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-236-5001
Provider Business Practice Location Address Fax Number:
314-569-0552
Provider Enumeration Date:
12/08/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DICKINSON
Authorized Official First Name:
KERRY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
314-600-8527

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  LC1173127 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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