NPI 1437389665

Moments of Serenity

Organisation Exclusive Provider Organization Washington, MO

Practice location

Address: 1380 High St Suite 3, Washington, MO 63090-4396
Phone: (636) 390-0047
Fax: (636) 390-9424

Authorised official

Name: Jennifer Marie Gildehaus-Balleydier
Title: Owner
Phone: (636) 390-0047

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Missouri →

Registry record

NPI: 1437389665
Entity type: Organization
NPI issued: 22 Jul 2009
Record last updated: 22 Jul 2009

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.