MEDICARE: LAKEISHA S GREENARD

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	:	1215891379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAKEISHA S GREENARD

Provider Business Mailing Address
First Line	:	2425 CALLE VISTA DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-7619
Country	:	US
Telephone Number	:	314-873-2431
Fax Number	:	314-873-2431

Provider Business Practice Location Address
First Line	:	2425 CALLE VISTA DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63031-7619
Country	:	US
Telephone Number	:	314-873-2431
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ LAKEISHA S GREENARD ” Practice Location

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