HAZELWOOD EAST – NPI #1114417342
Clinic/Center

HAZELWOOD EAST is an AHC clinic located in SAINT LOUIS, MO. NPPES has assigned the NPI number 1114417342 to HAZELWOOD EAST on May 14, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “HAZELWOOD EAST” is a dba name, the actual legal business name for this organization is CARESTL HEALTH. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 8 years ago on Sep 26, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HAZELWOOD EAST below.

NPI Profile for
CARESTL HEALTH

NPI Number
1114417342
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CARESTL HEALTH
Doing Business As (dba): HAZELWOOD EAST
Primary location
11300 DUNN RD
SAINT LOUIS, MO 63138
Phone: (314) 367-5820 Fax: (314) 367-6326
Mailing address
5471 DR MARTIN LUTHER KING DR
SAINT LOUIS, MO 63112-4265
Phone: (314) 367-5820 Fax: (314) 367-6326
Organization Subpart
No
Authorized Official
ANGEL CLABON
CHIEF EXECUTIVE OFFICER
Phone: (314) 367-5820
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
MO

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.