Provider Demographics
NPI:1548627862
Name:GOOD DAYS JOURNEY MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:GOOD DAYS JOURNEY MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERONDA
Authorized Official - Middle Name:RAMONA
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-387-6096
Mailing Address - Street 1:1 MID RIVERS MALL DR STE 280
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-4368
Mailing Address - Country:US
Mailing Address - Phone:636-387-6096
Mailing Address - Fax:636-387-6098
Practice Address - Street 1:1 MID RIVERS MALL DR STE 280
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-4368
Practice Address - Country:US
Practice Address - Phone:636-387-6096
Practice Address - Fax:636-387-6098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESOLUTIONS FOR PEOPLE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1821476474Medicaid
MO1013215128Medicaid