Provider Demographics
NPI:1528340841
Name:ST. LOUIS REGIONAL PSYCHIATRIC STABILIZATION CENTER
Entity type:Organization
Organization Name:ST. LOUIS REGIONAL PSYCHIATRIC STABILIZATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:EILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-488-6259
Mailing Address - Street 1:5355 DELMAR BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-3146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5355 DELMAR BOULEVARD
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-3146
Practice Address - Country:US
Practice Address - Phone:314-516-2658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital