MEDICARE: VISIONS OF SAINT LOUIS 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	:	1669839122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISIONS OF SAINT LOUIS LLC

Provider Business Mailing Address
First Line	:	9772 VICKIE PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-1911
Country	:	US
Telephone Number	:	314-366-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	9772 VICKIE PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-1911
Country	:	US
Telephone Number	:	314-366-0360
Fax Number	:

Authorized Official
Title or Position	:	CDS COORDINATOR
Name	:	YVETTE DUPREE
Credential	:
Telephone Number	:	314-366-0360

Provider Enumeration Date	:	01/28/2016
Last Update Date	:	01/28/2016

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Directions to “VISIONS OF SAINT LOUIS LLC ” Practice Location

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