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General NPI Number Information
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NPI Number | 1972289510
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Entity Type | Organization
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Legal Business Name | FAMILY LOVE HOME CARE OF MISSOURI LLC
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 4625 LINDELL BLVD STE 300
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City | SAINT LOUIS
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State | MO
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Zip | 63108-3725
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Country | US
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Telephone | 347-353-7560
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Fax |
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Provider Business Mailing Address
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Address Line | 123 MAPLE AVE STE 201A
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City | CEDARHURST
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State | NY
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Zip | 11516-2240
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BRETT LABRIE
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Credential |
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Telephone | 347-353-7560
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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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