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General NPI Number Information
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NPI Number | 1376465708
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Entity Type | Organization
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Legal Business Name | 3&1 ANGELS LLC
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Dates
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Enumeration Date | 07/28/2026
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Last Update Date | 07/28/2026
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Provider Practice Location Address
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Address Line | 119 CHURCH ST STE 224
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City | FERGUSON
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State | MO
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Zip | 63135-2460
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Country | US
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Telephone | 314-324-8739
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Fax | 314-224-1660
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Provider Business Mailing Address
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Address Line | 119 CHURCH ST STE 224
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City | FERGUSON
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State | MO
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Zip | 63135-2460
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Country | US
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Telephone | 314-324-8739
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Fax | 314-224-1660
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Authorized Official
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Title or Position | OWNER
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Name | QUITA HENDERSON
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Credential | LPN
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Telephone | 314-986-5241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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