Provider Demographics
NPI:1457617300
Name:CONTINUE CARE CONSUMER DIRECTED SERVICES
Entity Type:Organization
Organization Name:CONTINUE CARE CONSUMER DIRECTED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRAIN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-435-4596
Mailing Address - Street 1:8515 RIVERVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63147-1321
Mailing Address - Country:US
Mailing Address - Phone:314-435-4596
Mailing Address - Fax:314-754-9334
Practice Address - Street 1:8515 RIVERVIEW BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63147-1321
Practice Address - Country:US
Practice Address - Phone:314-435-4596
Practice Address - Fax:314-754-9334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization