| NPI | 1265639090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADONIA PAYNE WIKON Director 314-521-1569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: MO 266137207) |
| Additional Taxonomies | 251E00000X Home Health (Licence: MO 286137203) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |