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EDGEWOOD CHILDRENS CENTER
NPI 1659498996
Residential Treatment Facility, Emotionally Disturbed Children in Saint Louis, MO

Active since March 23, 2007
330 N GORE AVE, SAINT LOUIS, MO 63119(314) 968-2020(314) 968-8308 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Edgewood Childrens Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGEWOOD CHILDRENS CENTER (NPI 1659498996) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Saint Louis, Missouri and active in the NPI registry since March 2007. The organization lists Latriece Kimbrough, Cfo, as its authorized official.

NPPES Registry Identity

NPI1659498996
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameEDGEWOOD CHILDRENS CENTER
Location Address330 N GORE AVESaint Louis, MO 63119-1600
Mailing Address330 N Gore AveSaint Louis, MO 63119-1600 · (314) 968-2020 · Fax (314) 968-2060
Phone(314) 968-2020
Fax(314) 968-8308
Organization SubpartNo
Authorized OfficialLatriece KimbroughCfo · (314) 968-2060
Enumeration DateMarch 23, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1659498996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
330 N GORE AVE, Saint Louis, MO 63119
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAMMY L BUNGER COTA
Occupational Therapy Assistant
330 N GORE AVE
WEBSTER GROVES, MO 63119
St. Louis County (314) 968-2060
CHRISTINA KLASING RN
Registered Nurse
330 N GORE AVE
WEBSTER GROVES, MO 63119
St. Louis County (314) 919-4759
AI LING MOORE MSW, LCSW
Social Worker (Clinical)
330 N GORE AVE
WEBSTER GROVES, MO 63119
St. Louis County (314) 978-2060
SLPH, LLC
Community/Behavioral Health
330 N GORE AVE
WEBSTER GROVES, MO 63119
St. Louis County (913) 322-4900
MR. ROBERT JOSEPH PACANOWSKI II MA
Counselor (Professional)
330 N GORE AVE
SAINT LOUIS, MO 63119
St. Louis County (314) 968-2060
MRS. TAMESHA BLAND BCBA, LBA
Behavior Analyst
330 N GORE AVE
SAINT LOUIS, MO 63119
St. Louis County (314) 356-0538
MR. EDMUND B BOZESKY ACSW-LCSW
Social Worker (Clinical)
330 N GORE AVE
SAINT LOUIS, MO 63119
St. Louis County (314) 919-4700
MELISSA BRANSON
Occupational Therapist
330 N GORE AVE
SAINT LOUIS, MO 63119
St. Louis County (314) 919-4647

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgewood Childrens Center's NPI number?

The NPI number for Edgewood Childrens Center is 1659498996. It was assigned to this organization in the NPPES registry on March 23, 2007.

Where is Edgewood Childrens Center located?

Edgewood Childrens Center is located at 330 N Gore Ave, Saint Louis, MO 63119. The listed phone number is (314) 968-2020.

What is Edgewood Childrens Center's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Edgewood Childrens Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.