Organization
DIRECTOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS DICKINSON (DIRECTOR/COORDINATOR)
(314) 825-2084
Entity
Organization
Contact information
Practice address
625 N EUCLID AVE STE 302, SAINT LOUIS, MO 63108-1690
(314) 825-2084
Mailing address
1112 WILD PLUM DR, SAINT PETERS, MO 63303-1208
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/27/2014
Last updated
01/27/2014
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