Organization
ACTIVANGELS HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYNON MARSH (OWNER)
(314) 249-7003
Entity
Organization
Contact information
Practice address
4625 LINDELL BLVD STE 304, SAINT LOUIS, MO 63108
(314) 374-2094
Mailing address
4625 LINDELL BLVD STE 304, SAINT LOUIS, MO 63108-3729
(314) 374-2094
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
MO
Other
Enumeration date
06/01/2018
Last updated
08/07/2018
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