Provider Demographics
NPI:1811178585
Name:PRESBYTERIAN CHILDREN'S SERVICES, INC.
Entity type:Organization
Organization Name:PRESBYTERIAN CHILDREN'S SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP-PROGRAM
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GIEGLING
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:314-989-9727
Mailing Address - Street 1:1353 N WARSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-1807
Mailing Address - Country:US
Mailing Address - Phone:314-989-9727
Mailing Address - Fax:314-989-9709
Practice Address - Street 1:2740 E PYTHIAN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-2303
Practice Address - Country:US
Practice Address - Phone:417-862-9634
Practice Address - Fax:417-865-6507
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESBYTERIAN CHILDREN'S SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities