Provider Demographics
NPI:1245352764
Name:DARDENNE HEALTH SERVICES
Entity type:Organization
Organization Name:DARDENNE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:CULLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-469-9843
Mailing Address - Street 1:226 THF BLVD
Mailing Address - Street 2:NUMBER 403
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1136
Mailing Address - Country:US
Mailing Address - Phone:314-469-9843
Mailing Address - Fax:314-439-5154
Practice Address - Street 1:226 THF BLVD
Practice Address - Street 2:NUMBER 403
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-1136
Practice Address - Country:US
Practice Address - Phone:314-469-9843
Practice Address - Fax:314-439-5154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002024752111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty