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General NPI Number Information
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NPI Number | 1477085488
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Entity Type | Organization
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Legal Business Name | DELIGHTFUL JOURNEY CONSUMER DIRECT SERVICE LLC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 1451 MULLANPHY ST STE 105
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City | SAINT LOUIS
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State | MO
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Zip | 63106-3114
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Country | US
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Telephone | 314-327-0271
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Fax | 314-584-5045
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Provider Business Mailing Address
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Address Line | 1451 MULLANPHY ST STE 105
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City | SAINT LOUIS
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State | MO
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Zip | 63106-3114
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Country | US
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Telephone | 314-327-0271
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Fax | 314-584-5045
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MISS FELICIA D HAMPTON
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Credential | R.N.
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Telephone | 341-327-0271
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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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