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General NPI Number Information
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NPI Number | 1982815122
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Entity Type | Organization
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Legal Business Name | MISSOURI HAPPY HOMES
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Dates
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Enumeration Date | 05/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 375 VERSAILLES DR
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City | FLORISSANT
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State | MO
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Zip | 63031-2166
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Country | US
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Telephone | 314-838-3359
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Fax |
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Provider Business Mailing Address
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Address Line | 375 VERSAILLES DR
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City | FLORISSANT
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State | MO
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Zip | 63031-2166
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Country | US
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Telephone | 314-838-3359
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN AND CEO
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Name | MR. GEOFFREY SANKALE SOYIANTET
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Credential |
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Telephone | 314-838-3359
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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 | MO
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