Organization
HERBAL ENVY SKINCARE LLC
Active
Other names
Herbal Envy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA DAVIS BRADFORD (OWNER)
(314) 445-9164
Entity
Organization
Contact information
Practice address
12630 SHORESIDE DRIVE, FLORISSANT, MO 63033
(314) 824-8450
Mailing address
12630 SHORESIDE DR, FLORISSANT, MO 63033-5108
(314) 445-9164
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99-2115000
—
MO
Enumeration date
07/02/2019
Last updated
03/26/2024
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