Healthcare Provider Details

I. General information

NPI: 1114498862
Provider Name (Legal Business Name): WREN BLESSED CAREGIVERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 12/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8639 PARTRIDGE AVE
SAINT LOUIS MO
63147-1311
US

IV. Provider business mailing address

8639 PARTRIDGE AVE
SAINT LOUIS MO
63147-1311
US

V. Phone/Fax

Practice location:
  • Phone: 314-337-9063
  • Fax:
Mailing address:
  • Phone: 314-337-9063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BRANDY WREN
Title or Position: OWNER
Credential:
Phone: 314-337-9063