Provider Demographics
NPI:1629253380
Name:ST. CHARLES COUNTY ASSOCIATION FOR RETARDED CITIZENS
Entity Type:Organization
Organization Name:ST. CHARLES COUNTY ASSOCIATION FOR RETARDED CITIZENS
Other - Org Name:FAMILY SUPPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-946-2546
Mailing Address - Street 1:107 SHERIFF DIERKER CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-2468
Mailing Address - Country:US
Mailing Address - Phone:636-946-2546
Mailing Address - Fax:636-272-0258
Practice Address - Street 1:107 SHERIFF DIERKER CT
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-2468
Practice Address - Country:US
Practice Address - Phone:636-946-2546
Practice Address - Fax:636-272-0258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child