Healthcare Provider Details

I. General information

NPI: 1497291090
Provider Name (Legal Business Name): ANOINTING LOVING CARELLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5648 DR MARTIN LUTHER KING DR
SAINT LOUIS MO
63112-3933
US

IV. Provider business mailing address

5648 DR MARTIN LUTHER KING DR
SAINT LOUIS MO
63112-3933
US

V. Phone/Fax

Practice location:
  • Phone: 314-899-0292
  • Fax: 314-892-0291
Mailing address:
  • Phone: 314-899-0292
  • Fax: 314-892-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number305R00000X
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LISA M REID ALLEN
Title or Position: OWNER
Credential:
Phone: 314-899-0292