MEDICARE: ARMOR OF LOVE HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1053085290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARMOR OF LOVE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	5621 DELMAR BLVD STE 107D
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63112-2660
Country	:	US
Telephone Number	:	314-664-9900
Fax Number	:	314-664-9901

Provider Business Practice Location Address
First Line	:	5621 DELMAR BLVD STE 107D
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63112-2660
Country	:	US
Telephone Number	:	314-664-9900
Fax Number	:	314-664-9901

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LAWANDA DAVIS
Credential	:
Telephone Number	:	314-664-9900

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	09/08/2021

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