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General NPI Number Information
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NPI Number | 1366727539
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Entity Type | Organization
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Legal Business Name | ENCHANTED HANDS HOME CARE LLC
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 01/18/2012
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Provider Practice Location Address
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Address Line | 1120 S 6TH STREET 1A
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City | SAINT LOUIS
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State | MO
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Zip | 63104-3628
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Country | US
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Telephone | 314-265-8889
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 S 6TH ST 1A
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City | SAINT LOUIS
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State | MO
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Zip | 63104-3602
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Country | US
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Telephone | 314-265-8889
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Fax |
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Authorized Official
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Title or Position | PRESEIDENT/CEO
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Name | LATISHA EARL
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Credential |
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Telephone | 314-265-8889
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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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