Provider Demographics
NPI:1669846101
Name:ST. LOUIS EFFORT FOR AIDS
Entity Type:Organization
Organization Name:ST. LOUIS EFFORT FOR AIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-645-6451
Mailing Address - Street 1:1027 S VANDEVENTER AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-3800
Mailing Address - Country:US
Mailing Address - Phone:314-645-6451
Mailing Address - Fax:314-645-6502
Practice Address - Street 1:1027 S VANDEVENTER AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-3800
Practice Address - Country:US
Practice Address - Phone:314-645-6451
Practice Address - Fax:314-645-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management