# IDALIA BLUE'S HOME HEALTH II LLC

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

## Provider details

- **NPI number:** 1780450122
- **Authorized official:** TRICIA COLEMAN (MANAGING MEMBER)
- **Authorized official phone:** (636) 328-9664

## Contact information

- **Practice address:** 10174 W FLORISSANT AVE \# 319, SAINT LOUIS, MO 63136-2104
- **Practice address phone:** (636) 328-9664
- **Mailing address:** 10174 W FLORISSANT AVE \# 319, SAINT LOUIS, MO 63136-2104
- **Mailing address phone:** (636) 328-9664

## Taxonomy

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

## Other

- **Enumeration date:** 11/28/2023
- **Last updated:** 02/05/2024