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General NPI Number Information
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NPI Number | 1568909992
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Entity Type | Organization
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Legal Business Name | DIVINE LOVE & WISDOM HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 5261 DELMAR BLVD STE 210A
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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 | 314-776-9272
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Fax |
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Provider Business Mailing Address
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Address Line | 6942 NORMANDALE DR
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City | SAINT LOUIS
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State | MO
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Zip | 63121-5236
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Country | US
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Telephone | 314-574-9891
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DELORES JONES
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Credential |
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Telephone | 314-574-9891
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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 | MO
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