Provider Demographics
NPI:1346620333
Name:COMMUNITY BEHAVIOR HEALTH
Entity Type:Organization
Organization Name:COMMUNITY BEHAVIOR HEALTH
Other - Org Name:YOUTH AND ADULT PROGRAM
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-556-4443
Mailing Address - Street 1:957 WHISPERING RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5523
Mailing Address - Country:US
Mailing Address - Phone:314-556-4443
Mailing Address - Fax:636-244-1265
Practice Address - Street 1:1027 S VANDEVENTER AVE FL 2
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-3856
Practice Address - Country:US
Practice Address - Phone:314-282-0804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY BEHAVIOR HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-04
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)