Provider Demographics
NPI:1609951151
Name:ST LOUIS CENTER FOR EXCEPTIONAL CHIDREN AND ADULTS
Entity Type:Organization
Organization Name:ST LOUIS CENTER FOR EXCEPTIONAL CHIDREN AND ADULTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RINALDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-475-8430
Mailing Address - Street 1:16195 OLD US 12
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118
Mailing Address - Country:US
Mailing Address - Phone:734-475-8430
Mailing Address - Fax:734-475-0310
Practice Address - Street 1:16195 OLD US 12
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118
Practice Address - Country:US
Practice Address - Phone:734-475-8430
Practice Address - Fax:734-475-0310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC1810201428320600000X
MI320600000X, 320600000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities