Provider Demographics
NPI:1124143946
Name:SERVICES BY DESIGN, INC.
Entity type:Organization
Organization Name:SERVICES BY DESIGN, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-629-3319
Mailing Address - Street 1:113 APPLEGATE LN
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3209
Mailing Address - Country:US
Mailing Address - Phone:314-629-3319
Mailing Address - Fax:
Practice Address - Street 1:113 APPLEGATE LN
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-3209
Practice Address - Country:US
Practice Address - Phone:314-629-3319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO5604-8883320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities