OrganizationActive
Interfaith Residence
NPI 1164235362 · Infectious Disease Physician · Saint Louis, MO
Provider details
- NPI number
- 1164235362
- Entity type
- Organization
- Primary specialty
- Infectious Disease PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Opal Jones, President & Ceo(314) 535-1919
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Primary Care Nurse Practitioner363LP2300X
Physician Assistants & Advanced Practice Nursing Providers
- Community Health Clinic/Center261QC1500X
Ambulatory Health Care Facilities
Practice location
1101 N Jefferson Ave
Saint Louis, MO 63106-2222
Phone: (314) 535-1919
Fax: (314) 535-0909
Approximate (ZIP-level) locationGet directions
Mailing address
1101 N Jefferson Ave
Saint Louis, MO 63106-2222
Other names (DBA / former)
- Doing business as
- Key Clinic
Registry dates
- Enumerated
- 2025-01-30
- Last updated
- 2025-12-29
- Certified
- 2025-12-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.