Healthcare Provider Details

I. General information

NPI: 1003397308
Provider Name (Legal Business Name): LRB HOME HEALTHCARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 BROOKES DR STE 123
HAZELWOOD MO
63042-2735
US

IV. Provider business mailing address

3525 ARPENT LN
FLORISSANT MO
63034-2203
US

V. Phone/Fax

Practice location:
  • Phone: 314-363-1853
  • Fax: 314-274-8920
Mailing address:
  • Phone: 314-363-1853
  • Fax: 314-274-8920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberLC982011
License Number StateMO

VIII. Authorized Official

Name: MRS. LISA RENEE BURMETT
Title or Position: OWNER
Credential:
Phone: 314-363-1853