Southside Wellness Center Inc

LBN: Southside Wellness Center Inc
Southside Wellness Center Inc is an health care organization with primary practice located at 3017 Park Ave , Saint Louis MO 63104-1433. The organization recently has 5 registered licenses in different health care specialties including Agencies / Home Health, Ambulatory Health Care Facilities / Adult Day Care, Transportation Services / Non-emergency Medical Transport (VAN), Nursing Service Related Providers / Chore Provider, Nursing Service Related Providers / Personal Care Attendant. Nursing Service Related Providers / Personal Care Attendant is the primary health care specialty. Southside Wellness Center Inc can be contacted via phone (314) 664-5024, or through Parram, Mary via phone (314) 664-5024.

Contact Information

Primary practice address
3017 Park Ave Saint Louis MO 63104-1433
Phone: (314) 664-5024
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Parram, Mary
Phone: (314) 664-5024

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X Missouri
Ambulatory Health Care Facilities / Adult Day Care 261QA0600X 291705606 Missouri
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X 851705608 Missouri
Nursing Service Related Providers / Chore Provider 372500000X 281705608 Missouri
Nursing Service Related Providers / Personal Care Attendant 3747P1801X 261705602 Missouri

Profile Details

NPI number 1649453796
LBN Legal business name Southside Wellness Center Inc
DBA Doing business as
Authorized official Parram, Mary
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2007
Last updated May 16th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1649453796 NPPES
Missouri Other 0000466 PROVIDER NUMBER
Missouri MEDICAID 291705606 PROVIDER NUMBER
Missouri MEDICAID 261705602 PROVIDER NUMBER
Missouri MEDICAID 281705608 PROVIDER NUMBER
Missouri MEDICAID 851705608 PROVIDER NUMBER

Popular Providers