Provider Demographics
NPI:1972852234
Name:MITCHELL RESOURCE CENTER FOR SOCIAL SERVICES
Entity Type:Organization
Organization Name:MITCHELL RESOURCE CENTER FOR SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-910-2476
Mailing Address - Street 1:1341 N KINGSHIGHWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63113-1415
Mailing Address - Country:US
Mailing Address - Phone:314-367-2633
Mailing Address - Fax:314-367-3064
Practice Address - Street 1:1341 N KINGSHIGHWAY BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63113-1415
Practice Address - Country:US
Practice Address - Phone:314-367-2633
Practice Address - Fax:314-367-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care