Provider Demographics
NPI:1487970364
Name:C & S FACILITIES LLC
Entity type:Organization
Organization Name:C & S FACILITIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHONTELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-565-4708
Mailing Address - Street 1:10501 HALLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-4422
Mailing Address - Country:US
Mailing Address - Phone:314-869-3059
Mailing Address - Fax:314-741-1258
Practice Address - Street 1:10501 HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-4422
Practice Address - Country:US
Practice Address - Phone:314-869-3059
Practice Address - Fax:314-741-1258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services