MEDICARE: ODESSA'S LOVE & CARE

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	1312151	MO

General Provider Information

NPI Number	:	1144667403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ODESSA'S LOVE & CARE

Provider Business Mailing Address
First Line	:	6326 GARFIELD AVE
Second Line	:	PO BOX 5849
City	:	SAINT LOUIS
State	:	MO
Zip	:	63134-1708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6326 GARFIELD AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63134-1708
Country	:	US
Telephone Number	:	314-757-6941
Fax Number	:

Authorized Official
Title or Position	:	CMT
Name	:	MRS. ROBIN SHERELL JONES
Credential	:
Telephone Number	:	314-757-6941

Provider Enumeration Date	:	05/28/2013
Last Update Date	:	05/28/2013

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Directions to “ODESSA'S LOVE & CARE ” Practice Location

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