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Organization
BLUE HAYVEN IN HOME HEALTH CARE LLC
Active
Organization
BLUE HAYVEN IN HOME HEALTH CARE LLC
Active
Other names
Blue Hayven In Home Health Care LLC
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE M BROCK-WILLIAMS (DIRECTOR)
(314) 440-8087
Entity
Organization
Contact information
Practice address
11553 WITHERSFIELD DR, SAINT LOUIS, MO 63138-1152
(314) 440-8087
Mailing address
11553 WITHERSFIELD DR, SAINT LOUIS, MO 63138-1152
(314) 440-8087
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
—
MO
302R00000X
Health Maintenance Organization
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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