Provider Demographics
NPI:1316410210
Name:S & T LLC.
Entity Type:Organization
Organization Name:S & T LLC.
Other - Org Name:S & T LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-898-4422
Mailing Address - Street 1:3053 W CRAIG RD # 282
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-5124
Mailing Address - Country:US
Mailing Address - Phone:312-898-4422
Mailing Address - Fax:
Practice Address - Street 1:3053 W CRAIG RD # 282
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5124
Practice Address - Country:US
Practice Address - Phone:312-898-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health