Healthcare Provider Details

I. General information

NPI: 1285988303
Provider Name (Legal Business Name): WILMA AND THE MESSENGERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 10/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10192 HALLS FERRY RD
SAINT LOUIS MO
63136-4314
US

IV. Provider business mailing address

10192 HALLS FERRY RD
SAINT LOUIS MO
63136-4314
US

V. Phone/Fax

Practice location:
  • Phone: 314-388-4100
  • Fax: 314-388-4849
Mailing address:
  • Phone: 314-388-4100
  • Fax: 314-388-4849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1075
License Number StateMO

VIII. Authorized Official

Name: MRS. WILMA WALKER
Title or Position: PRESIDENT
Credential:
Phone: 314-388-4100