NPI 1316005473

Provident

Organisation Preferred Provider Organization Arnold, MO

Practice location

Address: 3675 W Outer Rd 203, Arnold, MO 63010-5232
Phone: (314) 898-0102
Fax: (636) 296-3249

Authorised official

Name: Kristin Bulin
Title: Director of Counseling Division
Phone: (314) 371-6500

Registered specialties (2)

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence SW002589 (MO)

Other Preferred Provider Organization providers in Missouri →

Community Based Hospice Care Agency

Agencies Taxonomy 251G00000X Licence 002589 (MO)

Other Hospice Care, Community Based providers in Missouri →

Registry record

NPI: 1316005473
Entity type: Organization
NPI issued: 4 Dec 2006
Record last updated: 11 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.