| NPI | 1598205916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDEWOR BEN OSEVWE CEO 618-447-3448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport (Licence: MO 2012026743) |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness (Licence: MO 2012026743) |
| 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: MO 2012026743) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 2012026743) | |
| Enumeration Date | 2017-03-04 |
| Last Update Date | 2017-03-04 |