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Organization
HERBAL ENVY SKINCARE LLC
Active
Organization
HERBAL ENVY SKINCARE LLC
Active
Other names
Herbal Envy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA DAVIS BRADFORD (OWNER)
(314) 445-9164
Entity
Organization
Contact information
Practice address
12630 SHORESIDE DRIVE, FLORISSANT, MO 63033
(314) 824-8450
Mailing address
12630 SHORESIDE DR, FLORISSANT, MO 63033-5108
(314) 445-9164
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99-2115000
—
MO
Enumeration date
07/02/2019
Last updated
03/26/2024
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