OrganizationActive
12 and Beyond Mo LLC
NPI 1093651150 · Substance Abuse Rehabilitation Facility · Saint Louis, MO
Provider details
- NPI number
- 1093651150
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Authorized official
- Peter Gifford, Chief Executive Officer
Practice location
4700 Hampton Ave
Saint Louis, MO 63109-2718
Phone: (602) 816-9421
Fax: (954) 301-8110
Mailing address
4700 Hampton Ave
Saint Louis, MO 63109-2718
Registry dates
- Enumerated
- 2026-04-28
- Last updated
- 2026-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.