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General NPI Number Information
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NPI Number | 1700304409
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Entity Type | Organization
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Legal Business Name | LISA R. BURNETT DBA LRB HOME HEALTH CARE AGENCY
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 4400 EMINENCE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63134-3420
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Country | US
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Telephone | 314-363-1853
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Fax |
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Provider Business Mailing Address
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Address Line | 320 BROOKES DRIVE SUITE 102
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City | ST. LOUIS
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State | MO
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Zip | 63134
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Country | US
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Telephone | 314-363-1853
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LISA RENEE BURNETT
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Credential |
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Telephone | 314-363-1853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | LC9821011
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License Number State | MO
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