Healthcare Provider Details

I. General information

NPI: 1497614804
Provider Name (Legal Business Name): ESSIES GENTLE TOUCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4236 E KOSSUTH AVE
SAINT LOUIS MO
63115-3405
US

IV. Provider business mailing address

4236 E KOSSUTH AVE
SAINT LOUIS MO
63115-3405
US

V. Phone/Fax

Practice location:
  • Phone: 314-930-6987
  • Fax:
Mailing address:
  • Phone: 314-930-6987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHNNA MARTIN
Title or Position: MEMBER
Credential:
Phone: 314-930-6987