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General NPI Number Information
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NPI Number | 1356947956
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Entity Type | Organization
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Legal Business Name | HEART & SOUL HEALTH LLC
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 2065 WALTON RD STE 412
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City | OVERLAND
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State | MO
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Zip | 63114-5805
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Country | US
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Telephone | 314-380-0492
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Fax | 314-720-6263
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Provider Business Mailing Address
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Address Line | 1016 ADVOCATE CT
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City | FLORISSANT
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State | MO
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Zip | 63034-2061
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Country | US
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Telephone | 314-548-3100
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Fax | 314-720-6263
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. GENE BORDERS JR.
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Credential |
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Telephone | 314-380-0492
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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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