1982573507 NPI number — DOROTHY JEAN COMPREHENSIVE NURSING COMMUNITY, LLC

Table of content: PAUL WELLIN CAMT, M.A. (NPI 1942857198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982573507 NPI number — DOROTHY JEAN COMPREHENSIVE NURSING COMMUNITY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOROTHY JEAN COMPREHENSIVE NURSING COMMUNITY, 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:
1982573507
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1293 KENNEBEC RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTERFIELD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63017-1929
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-237-7210
Provider Business Mailing Address Fax Number:
314-237-7280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 AIRPORT RD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FERGUSON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63135-1931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-237-7210
Provider Business Practice Location Address Fax Number:
314-237-7208
Provider Enumeration Date:
11/03/2025

Additional Information

Authorized Official

Authorized Official Last Name:
MCNARY
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
PATRICE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR/ OWNER
Authorized Official Telephone Number:
314-326-7441

Provider Taxonomy Codes

  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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