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General NPI Number Information
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NPI Number | 1457055782
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Entity Type | Organization
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Legal Business Name | MARILYN'S DAUGHTERS HOME CARE, LLC
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 8011 CLAYTON RD STE 110
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1156
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Country | US
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Telephone | 314-376-4500
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Fax | 314-376-4501
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Provider Business Mailing Address
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Address Line | 325 HYDE PARK AVE
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City | BELLWOOD
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State | IL
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Zip | 60104-1337
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LAKESHA BATTLE LEWIS
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Credential |
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Telephone | 314-376-4500
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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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