Provider Demographics
NPI:1568990505
Name:TYREE EDWARD MILLER BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:TYREE EDWARD MILLER BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TYREE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-853-9839
Mailing Address - Street 1:2829 GAINSBORO CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4717
Mailing Address - Country:US
Mailing Address - Phone:314-853-9839
Mailing Address - Fax:
Practice Address - Street 1:2829 GAINSBORO CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-4717
Practice Address - Country:US
Practice Address - Phone:314-853-9839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health