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Organization
LEGACY CONSUMER DIRECTED SERVICES LLC
Active
Organization
LEGACY CONSUMER DIRECTED SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ZAMIKA A WALLS (DIRECTOR)
(314) 478-4188
Entity
Organization
Contact information
Practice address
111 W PORT PLZ, 600, SAINT LOUIS, MO 63146-3011
(314) 478-4188
(314) 542-1542
Mailing address
111 W PORT PLZ, 600, SAINT LOUIS, MO 63146-3011
(314) 478-4188
(314) 542-1542
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
000090
MO
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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