Provider Demographics
NPI:1558601518
Name:HABIF HEALTH AND WELLNESS CENTER
Entity Type:Organization
Organization Name:HABIF HEALTH AND WELLNESS CENTER
Other - Org Name:STUDENT HEALTH SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARP
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:314-935-6649
Mailing Address - Street 1:1 BROOKINGS DR
Mailing Address - Street 2:CB 1201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4862
Mailing Address - Country:US
Mailing Address - Phone:314-935-6666
Mailing Address - Fax:314-935-5781
Practice Address - Street 1:6643 SHEPLEY DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-2354
Practice Address - Country:US
Practice Address - Phone:314-935-6649
Practice Address - Fax:314-935-5781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WASHINGTON UNIVERSITY IN ST. LOUIS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health