The Petrova House

LBN: The Community Counseling & Housing Services
The Petrova House is an health care organization with primary practice located at 2407 Petrova Ave , Jennings MO 63136-3903. The organization recently has 9 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Agencies / Case Management, Agencies / In Home Supportive Care, Ambulatory Health Care Facilities / VA, Nursing & Custodial Care Facilities / Assisted Living, Mental Illness, Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances, Residential Treatment Facilities / Psychiatric Residential Treatment Facility, Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, Suppliers / Managed Care Organization Pharmacy. Nursing & Custodial Care Facilities / Assisted Living, Mental Illness is the primary health care specialty. The Community Counseling & Housing Services can be contacted via phone (314) 580-3029, or through Shelton, Marvin via phone (314) 580-3029.

Contact Information

Primary practice address
2407 Petrova Ave Jennings MO 63136-3903
Phone: (314) 580-3029
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Shelton, Marvin ED.S, ED.D, RADC-P
Phone: (314) 580-3029

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Agencies / Case Management 251B00000X
Agencies / In Home Supportive Care 253Z00000X
Ambulatory Health Care Facilities / VA 261QV0200X
Nursing & Custodial Care Facilities / Assisted Living, Mental Illness 3104A0625X
Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances 3104A0630X
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X
Suppliers / Managed Care Organization Pharmacy 3336M0003X

Profile Details

NPI number 1477052058
LBN Legal business name The Community Counseling & Housing Services
DBA Doing business as The Petrova House
Authorized official Shelton, Marvin ED.S, ED.D, RADC-P
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2018
Last updated Feb 8th, 2018 - about 7 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.

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