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Organization
AGING WELL HEALTH CARE, LLC
Active
Organization
AGING WELL HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA BURSAK (ADMINISTRATOR)
(314) 726-5600
Entity
Organization
Contact information
Practice address
7212 BALSON AVE, SAINT LOUIS, MO 63130-3001
(314) 726-5600
(314) 754-9317
Mailing address
7212 BALSON AVE, SAINT LOUIS, MO 63130-3001
(314) 726-5600
(314) 754-9317
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
1010588
IL
251E00000X
Home Health Agency
Primary
755
MO
251J00000X
Nursing Care Agency
265855403
MO
261QA0600X
Adult Day Care Clinic/Center
609
MO
261QP2000X
Physical Therapy Clinic/Center
266633
MO
261QX0100X
Occupational Medicine Clinic/Center
266633
MO
385H00000X
Respite Care
285855409
MO
Other
Enumeration date
07/19/2005
Last updated
09/20/2010
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