Provider Demographics
NPI:1295166155
Name:LIFEQUEST CHRISTIAN COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:LIFEQUEST CHRISTIAN COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:GLADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-830-9970
Mailing Address - Street 1:580 N HIGHWAY 67 STE 9
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-5130
Mailing Address - Country:US
Mailing Address - Phone:314-830-9970
Mailing Address - Fax:314-529-3351
Practice Address - Street 1:580 N HIGHWAY 67 STE 9
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5130
Practice Address - Country:US
Practice Address - Phone:314-830-9970
Practice Address - Fax:314-529-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health