Healthcare Provider Details

I. General information

NPI: 1508530262
Provider Name (Legal Business Name): ALL SECURE FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9066 MIDDLEWOOD CT
SAINT LOUIS MO
63127-1312
US

IV. Provider business mailing address

3636 S GEYER RD STE 100
SAINT LOUIS MO
63127-1237
US

V. Phone/Fax

Practice location:
  • Phone: 910-527-6969
  • Fax:
Mailing address:
  • Phone: 910-527-6969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: DENISE ALICE DELELLIS
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 910-527-6969