Provider Demographics
NPI:1629037544
Name:EVANGELICAL CHILDREN'S HOME
Entity Type:Organization
Organization Name:EVANGELICAL CHILDREN'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR CLERK
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-427-3755
Mailing Address - Street 1:8240 SAINT CHARLES ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-4508
Mailing Address - Country:US
Mailing Address - Phone:314-427-3755
Mailing Address - Fax:314-426-0764
Practice Address - Street 1:8240 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-4508
Practice Address - Country:US
Practice Address - Phone:314-427-3755
Practice Address - Fax:314-426-0764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 101YS0200X, 104100000X, 1041C0700X, 1041S0200X, 106H00000X, 322D00000X
MO01716235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Single Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Not Answered322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children