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Organization
LIVE INDEPENDENT CONSUMER DIRECT LLC
Active
Organization
LIVE INDEPENDENT CONSUMER DIRECT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAURY CLAY (DIRECTOR/OWNER)
(314) 680-1976
Entity
Organization
Contact information
Practice address
320 BROOKES DR STE 203, HAZELWOOD, MO 63042-2740
(314) 680-1976
(314) 551-9881
Mailing address
320 BROOKES DR STE 203, HAZELWOOD, MO 63042-2740
(314) 680-1976
(314) 551-9881
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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