Organization
GIBSON WHITE DRAKE LLC
Active
Other names
Jewel House
Organization subpart
No
Provider details
NPI number
Authorized official
VERNISIA WHITE (OWNER)
(314) 246-9852
Entity
Organization
Contact information
Practice address
11423 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2724
(314) 246-9852
Mailing address
11423 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2724
(314) 246-9852
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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