# MATTIE'S ADHC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154679132
- **Authorized official:** IRENE SMITH HALL (PRESIDENT)
- **Authorized official phone:** (314) 960-2297

## Contact information

- **Practice address:** 1120 S 6TH ST, SAINT LOUIS, MO 63104-3602
- **Practice address phone:** (314) 588-7800
- **Mailing address:** 7119 WILLOW TREE LN, SAINT LOUIS, MO 63130-1819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/22/2012
- **Last updated:** 08/22/2012