Provider Demographics
NPI:1144520008
Name:BJC BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:BJC BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BALRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTHI
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:314-206-3912
Mailing Address - Street 1:1 BON PRICE TER
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-3705
Mailing Address - Country:US
Mailing Address - Phone:314-872-8974
Mailing Address - Fax:
Practice Address - Street 1:343 S KIRKWOOD RD STE 200
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6195
Practice Address - Country:US
Practice Address - Phone:314-206-3912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BJC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management