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Organization
GWD ASSISTED LIVING LLC
Active
Organization
GWD ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VERNISIA WHITE (BUSINESS OWNER)
(314) 246-9852
Entity
Organization
Contact information
Practice address
11423 SAINT CHARLES ROCK RD, HAZELWOOD, MO 63044-2724
(314) 246-9852
Mailing address
11423 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2724
(314) 246-9852
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
261QP2000X
Physical Therapy Clinic/Center
—
NULL
320700000X
Physical Disabilities Residential Treatment Facility
—
NULL
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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