Healthcare Provider Details

I. General information

NPI: 1902890353
Provider Name (Legal Business Name): ADDS HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 UNION BLVD
SAINT LOUIS MO
63108-1038
US

IV. Provider business mailing address

720 UNION BLVD
SAINT LOUIS MO
63108-1038
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-9900
  • Fax: 314-454-9600
Mailing address:
  • Phone: 314-454-9900
  • Fax: 314-454-9600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number756
License Number StateMO

VIII. Authorized Official

Name: MRS. DONZA Y HOPGOOD
Title or Position: CEO ADMINISTRATOR
Credential:
Phone: 314-454-9900