Organization
CARE 4 LIFE MEDICAL RESOURCES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTANAIA MILLER (OWNER)
(314) 972-9400
Entity
Organization
Contact information
Practice address
11830 W FLORISSANT AVE, FLORISSANT, MO 63033-6745
(314) 972-9400
Mailing address
11830 W FLORISSANT AVE, FLORISSANT, MO 63033-6745
(314) 972-9400
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
860
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346342672
—
MO
05
—
M286234901
—
MO
Enumeration date
06/04/2010
Last updated
06/04/2010
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