Provider Demographics
NPI:1023618014
Name:R &R RESIDENTIAL CARE LLC
Entity type:Organization
Organization Name:R &R RESIDENTIAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONVERSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-355-8041
Mailing Address - Street 1:17025 OLD JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-1414
Mailing Address - Country:US
Mailing Address - Phone:314-355-8041
Mailing Address - Fax:
Practice Address - Street 1:17025 OLD JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-1414
Practice Address - Country:US
Practice Address - Phone:314-355-8041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility