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General NPI Number Information
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NPI Number | 1538865498
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Entity Type | Organization
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Legal Business Name | MY GAUDIAN ANGELS LLC
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Dates
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Enumeration Date | 02/02/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 9191 W FLORISSANT AVE STE 214 B
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City | SAINT LOUIS
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State | MO
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Zip | 63136-1424
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Country | US
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Telephone | 314-459-3349
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Fax |
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Provider Business Mailing Address
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Address Line | 9191 W FLORISSANT AVE STE 214 B
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City | SAINT LOUIS
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State | MO
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Zip | 63136-1424
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Country | US
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Telephone | 314-459-3349
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATOSHA WARD
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Credential |
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Telephone | 314-459-3349
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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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