Provider Demographics
NPI:1407923766
Name:OUR LITTLE HAVEN
Entity Type:Organization
Organization Name:OUR LITTLE HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE AND OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:BAHLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-533-2229
Mailing Address - Street 1:4330 LINDELL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2702
Mailing Address - Country:US
Mailing Address - Phone:314-533-2229
Mailing Address - Fax:314-533-3098
Practice Address - Street 1:4330 LINDELL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2702
Practice Address - Country:US
Practice Address - Phone:314-533-2229
Practice Address - Fax:314-533-3098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare