# PHENOMINAL HEALTH SERVICES LLC

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

## Provider details

- **NPI number:** 1245003417
- **Authorized official:** JAMIE LAJAY BRACELY (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (314) 280-8565

## Contact information

- **Practice address:** 7517 HILLSDALE DR, SAINT LOUIS, MO 63121-4747
- **Practice address phone:** (314) 280-8565
- **Mailing address:** 7517 HILLSDALE DR, SAINT LOUIS, MO 63121-4747
- **Mailing address phone:** (314) 280-8565

## Taxonomy

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

## Other

- **Enumeration date:** 10/31/2023
- **Last updated:** 06/12/2024