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26D2044750 CLIA NUMBER - ALSANA - TWIN FAWNS

Laboratory Demographics

CLIA Number: 26D2044750

Facility Name: ALSANA - TWIN FAWNS

Facility Address:
1855 BOWLES AVENUE #210
FENTON, MO
ZIP 63026
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Facility Phone Number: 636 399-4524

Facility Type: Other - TREATMENT CENTER-EATING D

Certificate Type: Waiver
NPI Number: 1891463915

Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

CLIA Record

Field Name Field Value
CLIA Number 26D2044750
LAB Type Other - TREATMENT CENTER-EATING D
Facility Name ALSANA - TWIN FAWNS
Street 1855 BOWLES AVENUE #210
City FENTON
State MO
ZIP 63026
Phone 636 399-4524
CertificateType 4
CertificateEffectiveDate 7/31/2022
CertificateExpirationDate 7/30/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024