Provider Demographics
NPI:1447537071
Name:PSYCHIATRIC CARE AND RESEARCH CENTER INC
Entity type:Organization
Organization Name:PSYCHIATRIC CARE AND RESEARCH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CANALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:636-244-3589
Mailing Address - Street 1:4132 KEATON CROSSING BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8222
Mailing Address - Country:US
Mailing Address - Phone:636-244-3589
Mailing Address - Fax:636-244-3594
Practice Address - Street 1:4132 KEATON CROSSING BLVD
Practice Address - Street 2:STE 201
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8222
Practice Address - Country:US
Practice Address - Phone:636-244-3589
Practice Address - Fax:636-244-3594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty