FULL POTENTIAL RESIDENTIAL SERVICES LLC NPI 1730337114

NPI Information

FULL POTENTIAL RESIDENTIAL SERVICES, LLC 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. FULL POTENTIAL RESIDENTIAL SERVICES, LLC NPI is 1730337114. The provider is registered as an organization entity type.

The provider's business location address is:

8208 PAGE AVE
SAINT LOUIS, MO
ZIP 63130-115
Phone: (314) 839-9157
Fax: (314) 839-9157

The provider's authorized official is Demetra Evon Roberts .
The authorized official title is Administrator and has the following contact phone number (314) 839-9157.

The enumeration date for this NPI number is 8/28/2008 and was last updated on 8/28/2008.

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:

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