MEDICARE: FRIENDS FOR LIFE 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	:	1588201271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDS FOR LIFE LLC

Provider Business Mailing Address
First Line	:	7529 LYNN AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-1309
Country	:	US
Telephone Number	:	314-600-8105
Fax Number	:

Provider Business Practice Location Address
First Line	:	7529 LYNN AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-1309
Country	:	US
Telephone Number	:	314-600-8105
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DONESHIA ROSEITA SAUNDERS
Credential	:
Telephone Number	:	314-600-8105

Provider Enumeration Date	:	12/02/2019
Last Update Date	:	12/02/2019

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Directions to “FRIENDS FOR LIFE LLC ” Practice Location

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