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1982065454
SUPPORT INDEPENDENCE LLC
FLORISSANT, MO
NPI
1982065454
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Entity Type
Organization
Authorized Contact
TIMOTHY SHONTEZ MACON
CEO/Owner
314-504-1459
Organization Subpart ?
No
Primary Taxonomy
251E00000X Home Health
Enumeration Date
2016-03-11
Last Update Date
2016-03-11
Business Address
SUPPORT INDEPENDENCE LLC
625 LOYOLA DR
FLORISSANT, MO 63031-7231
Phone number: 314-504-1459
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Mailing Address
SUPPORT INDEPENDENCE LLC
625 LOYOLA DR
FLORISSANT, MO 63031-7231
Phone number: 314-504-1459
Copy
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