| NPI | 1114620887 |
|---|---|
| Former Legal Business Name | MRS OCTAVIA HOME HEALTH CARE LLC |
| Entity Type | Organization |
| Authorized Contact | DEBRA EDWARDS Director 314-652-4209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2023-10-04 |