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NPI 1134755291

NPI 1134755291 : A HART OF PEARLS HEALTHCARE LLC : SAINT LOUIS, MO

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General NPI Number Information
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    NPI Number           |    1134755291
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    Entity Type          |    Organization 
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    Legal Business Name  |    A HART OF PEARLS HEALTHCARE LLC 
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Dates
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    Enumeration Date     |    03/20/2020
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    Last Update Date     |    03/20/2020
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Provider Practice Location Address
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    Address Line         |    12412 LUSHER RD 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63138-1456
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    Country              |    US
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    Telephone            |    314-942-7414
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    Fax                  |    314-942-8041
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Provider Business Mailing Address
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    Address Line         |    12412 LUSHER RD 
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    City                 |    SAINT LOUIS
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    State                |    MO
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    Zip                  |    63138-1456
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    Country              |    US
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    Telephone            |    314-942-7414
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    Fax                  |    314-942-8041
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     BREANNA R WHITE 
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    Credential           |    
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    Telephone            |    314-942-7414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    
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