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General NPI Number Information
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NPI Number | 1689925752
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Entity Type | Organization
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Legal Business Name | NBA HEALTHCARE
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Dates
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Enumeration Date | 09/28/2012
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Last Update Date | 09/28/2012
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Provider Practice Location Address
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Address Line | 1811 SHERMAN DR SUITE 3
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City | SAINT CHARLES
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State | MO
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Zip | 63303-3976
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Country | US
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Telephone | 636-866-0722
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Fax | 636-866-0729
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Provider Business Mailing Address
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Address Line | 1811 SHERMAN DR SUITE 3
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City | SAINT CHARLES
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State | MO
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Zip | 63303-3976
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Country | US
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Telephone | 636-866-0722
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Fax | 636-866-0729
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM H ALLEN
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Credential |
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Telephone | 636-866-0722
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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 | 21643369
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License Number State | MO
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