Provider Demographics
NPI:1710266184
Name:CENTRAL INSTITUTE FOR TEH DEAF
Entity Type:Organization
Organization Name:CENTRAL INSTITUTE FOR TEH DEAF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-977-0227
Mailing Address - Street 1:825 S TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1567
Mailing Address - Country:US
Mailing Address - Phone:314-977-0134
Mailing Address - Fax:314-977-0023
Practice Address - Street 1:825 S TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1567
Practice Address - Country:US
Practice Address - Phone:314-977-0134
Practice Address - Fax:314-977-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency