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General NPI Number Information
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NPI Number | 1790318327
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Entity Type | Organization
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Legal Business Name | ABUNDANTLY ANGELS CONSUMER DIRECTED SERVICES LLC
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Dates
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Enumeration Date | 02/21/2020
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 2705 SAINT PETERS HOWELL RD STE L
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City | SAINT PETERS
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State | MO
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Zip | 63376-2821
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Country | US
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Telephone | 314-585-3074
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Fax | 363-222-9585
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Provider Business Mailing Address
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Address Line | 2705 SAINT PETERS HOWELL RD STE L
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City | SAINT PETERS
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State | MO
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Zip | 63376-2821
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Country | US
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Telephone | 314-585-3074
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Fax | 363-222-9585
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Authorized Official
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Title or Position | CEO
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Name | MS. ANGELA MARLETT
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Credential |
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Telephone | 636-970-9848
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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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