Organization
IDALIA BLUE'S HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA COLEMAN (MANAGING MEMBER)
(636) 328-9664
Entity
Organization
Contact information
Practice address
10174 W FLORISSANT AVE STE 319, SAINT LOUIS, MO 63136-2104
(636) 328-9664
Mailing address
6221 GREER AVE, SAINT LOUIS, MO 63121-5617
(636) 328-9664
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
01/25/2024
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