Organization
1ST HOME AWAY FROM HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWANDA GUEST (EXECUTIVE DIRECTOR)
(314) 479-1673
Entity
Organization
Contact information
Practice address
4735 PLOVER AVE, SAINT LOUIS, MO 63120-1822
(314) 479-1673
Mailing address
4735 PLOVER AVE, SAINT LOUIS, MO 63120-1822
(314) 479-1673
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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