JUDEVINE INC. NPI 1518291418

NPI Information

NPI: 1518291418
Provider Name: JUDEVINE, INC.

Doing Business As: JUDEVINE CENTER FOR AUTISM

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
1810 CRAIG RD STE 109
SAINT LOUIS, MO
ZIP 63146
Phone: (800) 780-6545
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JUDEVINE, INC. is a community based residential treatment facility, intellectual and/or developmental disabilities in Saint Louis, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. JUDEVINE, INC. NPI is 1518291418. The provider is registered as an organization entity type.
The provider Is Doing Business As Judevine Center For Autism.

The provider's business location address is:

1810 CRAIG RD STE 109
SAINT LOUIS, MO
ZIP 63146-758
Phone: (800) 780-6545
Fax: (888) 507-4453

The provider's authorized official is Rebecca Blackwell .
The authorized official title is President/director and has the following contact phone number (800) 780-6545.

The enumeration date for this NPI number is 9/24/2009 and was last updated on 1/7/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	251C00000X	Day Training, Developmentally Disabled Services			No
2	251S00000X	Community/Behavioral Health	ER019910064	MISSOURI	No
3	252Y00000X	Early Intervention Provider Agency			No
4	253Z00000X	In Home Supportive Care			No
5	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	ER019910064	MISSOURI	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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