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Organization
JETTIE B'S HEALTH CARE AGENCY LLC
Active
Organization
JETTIE B'S HEALTH CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHAKITA COBURN (OWNER)
(314) 551-2079
Entity
Organization
Contact information
Practice address
10420 OLD OLIVE STREET RD STE 206, SAINT LOUIS, MO 63141-5937
(314) 551-2079
Mailing address
10420 OLD OLIVE STREET RD STE 206, SAINT LOUIS, MO 63141-5937
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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