Healthcare Provider Details

I. General information

NPI: 1801268115
Provider Name (Legal Business Name): DLB HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 10/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RUE SAINT FRANCOIS SUITE 203
FLORISSANT MO
63031-5134
US

IV. Provider business mailing address

100 RUE SAINT FRANCOIS SUITE 203
FLORISSANT MO
63031-5134
US

V. Phone/Fax

Practice location:
  • Phone: 314-657-0061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMO

VIII. Authorized Official

Name: LOLETHA BEVLY
Title or Position: DIRECTOR
Credential:
Phone: 314-346-3380