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General NPI Number Information
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NPI Number | 1265702526
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Entity Type | Organization
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Legal Business Name | THE HEART OF DAVID IN-HOME SERVICE LLC
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 3236 LIBERTY ST
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City | SAINT LOUIS
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State | MO
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Zip | 63111-1701
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Country | US
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Telephone | 314-932-9848
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Fax | 314-832-5159
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Provider Business Mailing Address
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Address Line | 3236 LIBERTY ST
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City | SAINT LOUIS
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State | MO
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Zip | 63111-1701
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Country | US
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Telephone | 314-932-9848
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Fax | 314-832-5159
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. DONNA K BRYANT
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Credential |
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Telephone | 314-308-4590
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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 | MO
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Taxonomy #2
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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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