Provider Demographics
NPI:1851199517
Name:SOLACE THERAPY SERVICES LLC
Entity type:Organization
Organization Name:SOLACE THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KILEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ASCHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-261-0753
Mailing Address - Street 1:5527 WINONA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-1648
Mailing Address - Country:US
Mailing Address - Phone:605-261-0753
Mailing Address - Fax:
Practice Address - Street 1:4121 UNION RD STE 225
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1093
Practice Address - Country:US
Practice Address - Phone:605-261-0753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health