Organization
ANGELS ON CALL HOMECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY DOENICE CLAYTON LPN (OWNER)
(314) 971-6853
Entity
Organization
Contact information
Practice address
1923 SPRUCE ST, SAINT PETERS, MO 63376-6629
(314) 971-6853
Mailing address
1923 SPRUCE ST, SAINT PETERS, MO 63376-6629
(314) 971-6853
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2014004364
MO
251E00000X
Home Health Agency
Primary
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014004364
LPN
MO
Enumeration date
05/19/2018
Last updated
05/19/2018
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