Provider Demographics
NPI:1538332002
Name:THE CENTER FOR HEAD INJURY SERVICES
Entity Type:Organization
Organization Name:THE CENTER FOR HEAD INJURY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUNNING
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CRC, LPC
Authorized Official - Phone:314-983-9230
Mailing Address - Street 1:11786 WESTLINE INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3402
Mailing Address - Country:US
Mailing Address - Phone:314-983-9230
Mailing Address - Fax:314-983-9235
Practice Address - Street 1:11786 WESTLINE INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3402
Practice Address - Country:US
Practice Address - Phone:314-983-9230
Practice Address - Fax:314-983-9235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services