Provider Demographics
NPI:1265629117
Name:LUTHERAN FAMILY & CHILDREN'S SERVICES OF MO
Entity Type:Organization
Organization Name:LUTHERAN FAMILY & CHILDREN'S SERVICES OF MO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ERDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-787-5100
Mailing Address - Street 1:8631 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1990
Mailing Address - Country:US
Mailing Address - Phone:314-787-5100
Mailing Address - Fax:314-754-2800
Practice Address - Street 1:2800 ELM ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-4618
Practice Address - Country:US
Practice Address - Phone:314-787-5100
Practice Address - Fax:314-754-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007001396251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management