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General NPI Number Information
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NPI Number | 1629080189
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Entity Type | Organization
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Legal Business Name | ST. ANDREW'S AT HOME SERVICES, LLC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 6633 DELMAR BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63130-4505
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Country | US
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Telephone | 314-726-5766
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Fax |
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Provider Business Mailing Address
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Address Line | 6633 DELMAR BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63130-4505
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Country | US
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Telephone | 314-726-5766
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | ANN R BANNES
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Credential |
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Telephone | 314-802-2192
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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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