KIRWOOD MEDICATION ASSISTED TREATMENTS


Address: 111 Prospect Ave Ste 201, Kirkwood, MO 63122-6052
Phone: 3146448310

KIRWOOD MEDICATION ASSISTED TREATMENTS (NPI# 1053953422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053953422
Entity Type Organization
Organization Name KIRWOOD MEDICATION ASSISTED TREATMENTS
Practice Address 111 Prospect Ave Ste 201
Kirkwood
MO 63122-6052
Practice Telephone 3146448310
Practice Fax Number 3142936749
Mailing Telephone 3146448310
Mailing Fax Number 3142936749
Enumeration Date 2019-10-17
Last Update Date 2020-05-25
Authorized Official Name DR. GARY HAMMEN (MEMBER)
Authorized Official Telephone 3146448310
Authorized Official Credential MD PHD
Is Organization Subpart Y
Parent Organization Name DR GARY HAMMEN MD PHD LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Kirkwood Medication Assisted Treatments Doing Business As Name - Organization

Office Location

Street Address 111 PROSPECT AVE STE 201
City KIRKWOOD
State MO
Zip Code 63122-6052

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659933174 Keela Rushing Physical Therapist 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 2019-07-04
1730643461 Kirkwood Family Dental Dentist 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 2019-01-28
1477061166 Total Access Urgent Care, PC Clinic/Center 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 2018-01-16
1760933469 Missouri Cvs Pharmacy, L.l.c Durable Medical Equipment & Medical Supplies 10820 Manchester Rd, Kirkwood, MO 63122 2016-10-18
1518321041 M. Kathleen Blanchard Counselor 11042 Manchester Rd., Kirkwood, MO 63122 2016-04-11
1265801914 Kim Grega Counselor 700 S Kirkwood Rd, Kirkwood, MO 63122 2015-09-23
1245617943 Mark Edward Taylor Dentist 610 North Geyer, Kirkwood, MO 63122 2015-05-01
1467843094 Mary Elizabeth Boomgarden Physical Therapist 9645 Big Bend Boulevard, Saint Louis, MO 63122 2015-02-18
1760725717 Michael Diller Counseling Counselor 144 W Madison Avenue, Kirkwood, MO 63122 2013-03-28
1427309954 Anne Marie Delaplain Dentist 725 Laclede Station Road, Webster Groves, MO 63122 2012-09-24
Find all providers in zip 63122

Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376973727 Northbound Treatment Services of Missouri Clinic/Center 333 S Kirkwood Rd Ste 303, Kirkwood, MO 63122-6161 2013-11-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1487179057 Gateway Foundation, Inc. Clinic/Center 1430 Olive St Ste 300, Saint Louis, MO 63103-2303 2017-08-04
1700233145 New Beginnings C-star Clinic/Center 1408 N Kingshighway Blvd Ste 4, Saint Louis, MO 63113-1426 2016-05-16
1629432182 Clark Community Mental Health Center Clinic/Center 1701 N Central Ave, Monett, MO 65708 2016-04-11
1083024061 Avertest, LLC Clinic/Center 4709 Laguardia Dr, Suite 100, Saint Louis, MO 63134 2014-04-30
1659718609 Hannibal Council On Alcohol & Drug Abuse Clinic/Center 146 Communication Dr, Hannibal, MO 63401-3672 2013-05-31
1194026765 Family Counseling Center, Inc. Clinic/Center 500 Us Hwy 61 North, Hayti, MO 63851 2010-11-12
1942501143 Swope Health Services Clinic/Center 3950 E 51st St, Kansas City, MO 64130-3081 2010-11-04
1750682043 Black Alcohol/drug Service Information Center Clinic/Center 3026 Locust St, Saint Louis, MO 63103-1329 2010-11-03
1932412186 Comprehensive Mental Health Services, Inc/renaisance West Clinic/Center 5840 Swope Pkwy, Kansas City, MO 64130-4262 2010-07-16
1609194448 Southeast Missouri Behavioral Health Clinic/Center 216 Piedmont Ave Ste 304, Piedmont, MO 63957-1017 2010-05-04
Find all providers with the same taxonomy

Competitor

Search similar providers

City KIRKWOOD
Zip Code 63122

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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