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General NPI Number Information
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NPI Number | 1285332809
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Entity Type | Organization
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Legal Business Name | LMD MANAGEMENT, INC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 5223 VILLE ANITA CT
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City | HAZELWOOD
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State | MO
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Zip | 63042-1608
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Country | US
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Telephone | 314-691-3189
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Fax | 314-786-5742
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Provider Business Mailing Address
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Address Line | 1525 VOLTAIRE DR
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3844
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Country | US
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Telephone | 314-691-3189
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Fax | 314-786-5742
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Authorized Official
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Title or Position | OWNER-MANAGER
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Name | MS. DEIDRE MICHELLE LEWIS
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Credential |
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Telephone | 314-691-3189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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