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General NPI Number Information
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NPI Number | 1649265562
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Entity Type | Organization
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Legal Business Name | DELMAR GARDENS PRIVATE SERVICES, LLC
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 14805 N OUTER 40 RD STE 320A
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City | CHESTERFIELD
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State | MO
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Zip | 63017-6021
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Country | US
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Telephone | 636-733-7100
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Fax | 636-733-7101
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Provider Business Mailing Address
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Address Line | 14805 N OUTER 40 RD STE 320A
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City | CHESTERFIELD
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State | MO
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Zip | 63017-6021
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Country | US
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Telephone | 636-733-7100
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Fax | 636-733-7101
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. BRYAN MICHAEL BACKOWSKI
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Credential |
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Telephone | 636-733-7330
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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