Provider Demographics
NPI:1508868852
Name:FATHER DUNNE'S NEWSBOYS HOME AND PROTECTORATE
Entity Type:Organization
Organization Name:FATHER DUNNE'S NEWSBOYS HOME AND PROTECTORATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPKINS-BURT
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:314-837-0513
Mailing Address - Street 1:853 DUNN RD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-8203
Mailing Address - Country:US
Mailing Address - Phone:314-837-0513
Mailing Address - Fax:314-837-0883
Practice Address - Street 1:853 DUNN RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8203
Practice Address - Country:US
Practice Address - Phone:314-837-0513
Practice Address - Fax:314-837-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children