Provider Demographics
NPI:1417181983
Name:IT TAKES A VILLAGE ENTERPRISES
Entity Type:Organization
Organization Name:IT TAKES A VILLAGE ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, ACSW, LCSW
Authorized Official - Phone:314-606-8908
Mailing Address - Street 1:PO BOX 38108
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-0108
Mailing Address - Country:US
Mailing Address - Phone:314-606-8908
Mailing Address - Fax:314-395-7001
Practice Address - Street 1:5800 NATURAL BRIDGE AVE
Practice Address - Street 2:N/A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63120-1434
Practice Address - Country:US
Practice Address - Phone:314-606-8908
Practice Address - Fax:314-395-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000165951251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health