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Contact Information

COMMUNITY AND LONG-TERM CARE PSYCHIATRY LLC
10004 KENNERLY RD STE 362B
SAINT LOUIS, MO63128-2178
 Phone: 314-525-5050
 Fax: 314-525-5072
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychosomatic Medicine

2084P0015X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for COMMUNITY AND LONG-TERM CARE PSYCHIATRY LLC

NPI # 1699121475
LBN Legal business name COMMUNITY AND LONG-TERM CARE PSYCHIATRY LLC
Authorized official ERNEST GRAYPEL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/10/2016
Last updated 01/17/2024 - About 2 years ago
Identifiers
MO License # 2015002634
MO Medicaid 1265723407
MO Other 156440095 MEDICARE
MO Other P01585490 RR MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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