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Organization
SUPREME LUXE HEALTH
Active
Organization
SUPREME LUXE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMEKA R ANDERSON (OWNER/NURSE)
(618) 219-5569
Entity
Organization
Contact information
Practice address
4818 WASHINGTON BLVD, SAINT LOUIS, MO 63108-1829
(314) 904-4770
Mailing address
4456 EVANS AVE, SAINT LOUIS, MO 63113-2719
(618) 219-5569
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
Primary
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QA0600X
Adult Day Care Clinic/Center
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
385H00000X
Respite Care
—
NULL
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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