Healthcare Provider Details

I. General information

NPI: 1639016389
Provider Name (Legal Business Name): EPIPHANY CDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3431 LOCUST ST
SAINT LOUIS MO
63103-1113
US

IV. Provider business mailing address

120 JOST MANOR DR
FLORISSANT MO
63034-2269
US

V. Phone/Fax

Practice location:
  • Phone: 314-348-2703
  • Fax:
Mailing address:
  • Phone: 314-249-5384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: LOUISE THOMAS
Title or Position: OWNER
Credential:
Phone: 314-249-5384