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Organization
AMITY AT HOME, LLC
Active
Organization
AMITY AT HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KISHA JACKSON (DIRECTOR)
(314) 329-7744
Entity
Organization
Contact information
Practice address
3920 LINDELL BLVD, SUITE 208, ST. LOUIS, MO 63108
(314) 329-7744
Mailing address
P.O. BOX 300502, ST. LOUIS, MO 63130
(314) 599-3652
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/08/2022
Last updated
06/25/2024
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