Organization
CROWN OF GLORY HOME HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONEY DIXON (CDS COORDINATOR)
(314) 874-2446
Entity
Organization
Contact information
Practice address
635 SAINT ANTHONY LN, FLORISSANT, MO 63033-5412
(314) 874-2446
Mailing address
635 SAINT ANTHONY LN, FLORISSANT, MO 63033-5412
(314) 874-2446
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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