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General NPI Number Information
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NPI Number | 1679360754
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Entity Type | Organization
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Legal Business Name | DLW DEVELOPMENT HEALTH LLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1515 N WARSON RD STE 217
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City | SAINT LOUIS
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State | MO
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Zip | 63132-1115
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Country | US
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Telephone | 314-458-8853
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 N WARSON RD STE 217
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City | SAINT LOUIS
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State | MO
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Zip | 63132-1115
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Country | US
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Telephone | 314-458-8853
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DAWN LAKEISHA WRIGHT
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Credential | PERSONAL CARE PROVID
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Telephone | 314-458-8853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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