# HEARTS OF GRACE CONSUMER DIRECTED SERVICES

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

## Provider details

- **NPI number:** 1689041469
- **Authorized official:** GLENDA LUCKETT (PRESIDENT/MANAGER)
- **Authorized official phone:** (314) 458-5246

## Contact information

- **Practice address:** 12033 BRIDGETON TRAILS CT, BRIDGETON, MO 63044-2875
- **Practice address phone:** (314) 458-5246
- **Mailing address:** 12033 BRIDGETON TRAILS CT, BRIDGETON, MO 63044-2875

## Taxonomy

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

## Other

- **Enumeration date:** 08/27/2015
- **Last updated:** 08/27/2015