| NPI | 1457797466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE MAHONEY Manager 314-504-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2023-03-24 |