# SUPREME LUXE HEALTH

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

## Provider details

- **NPI number:** 1881418002
- **Authorized official:** SHAMEKA R ANDERSON (OWNER/NURSE)
- **Authorized official phone:** (618) 219-5569

## Contact information

- **Practice address:** 4818 WASHINGTON BLVD, SAINT LOUIS, MO 63108-1829
- **Practice address phone:** (314) 904-4770
- **Mailing address:** 4456 EVANS AVE, SAINT LOUIS, MO 63113-2719
- **Mailing address phone:** (618) 219-5569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 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