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Organization

PHENOMINAL HEALTH SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE LAJAY BRACELY (EXECUTIVE DIRECTOR)
(314) 280-8565
Entity
Organization

Contact information

Practice address
7517 HILLSDALE DR, SAINT LOUIS, MO 63121-4747
(314) 280-8565
Mailing address
7517 HILLSDALE DR, SAINT LOUIS, MO 63121-4747
(314) 280-8565

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Enumeration date
10/31/2023
Last updated
06/12/2024
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