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General NPI Number Information
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NPI Number | 1174033013
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Entity Type | Organization
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Legal Business Name | WITH LOVE HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 57 GOCKE PL
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City | SAINT LOUIS
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State | MO
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Zip | 63114-1351
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Country | US
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Telephone | 314-600-8816
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Fax |
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Provider Business Mailing Address
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Address Line | 16756 STANFORD PLACE DR
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City | FLORISSANT
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State | MO
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Zip | 63034-3213
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Country | US
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Telephone | 314-719-9117
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER/CO-OWNER
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Name | ANISHA CALDWELL
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Credential |
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Telephone | 314-719-9117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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