Provider Demographics
NPI:1598823551
Name:ASSOCIATION ON AGING WITH DEVELOPMENTAL DISABILITIES
Entity Type:Organization
Organization Name:ASSOCIATION ON AGING WITH DEVELOPMENTAL DISABILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-647-8100
Mailing Address - Street 1:2385 HAMPTON AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-2932
Mailing Address - Country:US
Mailing Address - Phone:314-647-8100
Mailing Address - Fax:314-647-8105
Practice Address - Street 1:2385 HAMPTON AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-2932
Practice Address - Country:US
Practice Address - Phone:314-647-8100
Practice Address - Fax:314-647-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services