Healthcare Provider Details
I. General information
NPI: 1346870664
Provider Name (Legal Business Name): HONOR CDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/26/2020
Last Update Date: 01/26/2020
Certification Date: 01/26/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7918 DELMAR BLVD # A
SAINT LOUIS MO
63130-3715
US
IV. Provider business mailing address
7918 DELMAR BLVD # A
SAINT LOUIS MO
63130-3715
US
V. Phone/Fax
- Phone: 347-215-0124
- Fax:
- Phone: 347-215-0124
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NETANEL
COHN
Title or Position: CEO
Credential:
Phone: 347-215-0124