Provider Demographics
NPI:1922530096
Name:THE MISSING L INC
Entity Type:Organization
Organization Name:THE MISSING L INC
Other - Org Name:THE CROSSROADS PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WEILAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-532-9991
Mailing Address - Street 1:626 CEPI DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1221
Mailing Address - Country:US
Mailing Address - Phone:636-532-9991
Mailing Address - Fax:
Practice Address - Street 1:3605 S. PROVIDENCE RD
Practice Address - Street 2:SUITE 6
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203
Practice Address - Country:US
Practice Address - Phone:636-532-9991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health