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General NPI Number Information
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NPI Number | 1285190330
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Entity Type | Organization
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Legal Business Name | ELAINES LOVE & EMPOWERMENT LLC
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Dates
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Enumeration Date | 02/13/2019
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 9859 VENTURA DR
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City | SAINT LOUIS
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State | MO
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Zip | 63136-4130
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Country | US
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Telephone | 615-626-6546
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Fax |
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Provider Business Mailing Address
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Address Line | 9859 VENTURA DR
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City | SAINT LOUIS
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State | MO
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Zip | 63136-4130
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Country | US
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Telephone | 615-626-6546
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMILRAH SANFORD
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Credential |
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Telephone | 615-626-6546
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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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