Organization
MARTY'S MIRACULOUS PRIVATE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONA N BANKS (OWNER)
(314) 906-1020
Entity
Organization
Contact information
Practice address
3431 BRIDGELAND DR STE K, BRIDGETON, MO 63044-2648
(314) 906-1020
Mailing address
3431 BRIDGELAND DR STE K, BRIDGETON, MO 63044-2648
(314) 906-1020
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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