Provider Demographics
NPI:1437437399
Name:DESHAY OUTREACH CENTER
Entity Type:Organization
Organization Name:DESHAY OUTREACH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:DESHAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-388-2356
Mailing Address - Street 1:869 HARLAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63147-2023
Mailing Address - Country:US
Mailing Address - Phone:314-388-2356
Mailing Address - Fax:
Practice Address - Street 1:869 HARLAN AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63147-2023
Practice Address - Country:US
Practice Address - Phone:314-388-2356
Practice Address - Fax:314-388-2534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty