Provider Demographics
NPI:1659832079
Name:METRO NEUROHEALTH LLC
Entity Type:Organization
Organization Name:METRO NEUROHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCILLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-497-0500
Mailing Address - Street 1:3641 MEADOWGLEN CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6678
Mailing Address - Country:US
Mailing Address - Phone:314-497-0500
Mailing Address - Fax:
Practice Address - Street 1:3641 MEADOWGLEN CT
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-6678
Practice Address - Country:US
Practice Address - Phone:314-497-0500
Practice Address - Fax:573-501-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health