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General NPI Number Information
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NPI Number | 1831639129
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Entity Type | Organization
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Legal Business Name | WILLIAMS CONSUMERS DIRECTIVE, LLC
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 716 S FLORISSANT RD
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City | SAINT LOUIS
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State | MO
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Zip | 63135-2984
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Country | US
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Telephone | 314-522-8289
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Fax |
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Provider Business Mailing Address
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Address Line | 716 S FLORISSANT RD
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City | SAINT LOUIS
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State | MO
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Zip | 63135-2984
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Country | US
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Telephone | 314-522-8289
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANNIE J WILLIAMS
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Credential |
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Telephone | 314-522-8289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 1578843462
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License Number State | MO
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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 | 1578843462
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License Number State | MO
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