# VISION HOME HEALTH EXTENDED LLC

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

## Provider details

- **NPI number:** 1245731785
- **Authorized official:** LAURIE TILLMAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (314) 520-5952

## Contact information

- **Practice address:** 299 S FLORISSANT RD, FERGUSON, MO 63135-2735
- **Practice address phone:** (314) 520-5952
- **Practice address fax:** (314) 921-4902
- **Mailing address:** 849 N HIGHWAY 67 ST, FLORISSANT, MO 63031-2915
- **Mailing address phone:** (314) 520-5952

## Taxonomy

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

## Other

- **Enumeration date:** 02/21/2018
- **Last updated:** 07/31/2024