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General NPI Number Information
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NPI Number | 1407336373
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Entity Type | Organization
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Legal Business Name | ASG CDS LLC
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | 5261 DELMAR BLVD STE C
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1063
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Country | US
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Telephone | 314-327-1803
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Fax | 314-584-7001
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Provider Business Mailing Address
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Address Line | 4679 KOSSUTH AVE APT B
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City | SAINT LOUIS
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State | MO
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Zip | 63115-2405
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Country | US
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Telephone | 314-327-1803
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Fax | 314-584-7001
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Authorized Official
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Title or Position | OWNER
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Name | SHARON MARIE HOWARD
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Credential |
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Telephone | 314-327-1803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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