SOUTHSIDE WELLNESS CENTER INC NPI 1649453796

NPI Information

NPI: 1649453796
Provider Name: SOUTHSIDE WELLNESS CENTER INC
Classification: Technician - 3747P1801X
Entity Type: Organization

Specialization: Personal Care Attendant

Address:
3017 PARK AVE
SAINT LOUIS, MO
ZIP 63104
Phone: (314) 664-5024
Get Directions

SOUTHSIDE WELLNESS CENTER INC is a personal care attendant technician in Saint Louis, MO. The provider is an individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards SOUTHSIDE WELLNESS CENTER INC NPI is 1649453796. The provider is registered as an organization entity type.

The provider's business location address is:

3017 PARK AVE
SAINT LOUIS, MO
ZIP 63104-433
Phone: (314) 664-5024

The provider's authorized official is Mary Parram .
The authorized official title is ASSISTANT DIRECTORDirector and has the following contact phone number (314) 664-5024.

The enumeration date for this NPI number is 12/12/2007 and was last updated on 5/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251E00000X	Home Health			MISSOURI	No
2	261QA0600X	Clinic/Center	Adult Day Care	291705606	MISSOURI	No
3	372500000X	Chore Provider		281705608	MISSOURI	No
4	343900000X	Non-emergency Medical Transport (VAN)		851705608	MISSOURI	No
5	3747P1801X	Technician	Personal Care Attendant	261705602	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	281705608	MEDICAID	MISSOURI
2	261705602	MEDICAID	MISSOURI
3	0000466	OTHER	MISSOURI	PROVIDER NUMBER
4	851705608	MEDICAID	MISSOURI
5	291705606	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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