Organization
AGING WELL HEALTH CARE, LLC
Active
Other names
AW Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IRINA BURSAK (ADMINISTRATOR)
(314) 726-5600
Entity
Organization
Contact information
Practice address
540 REGENCY CTR, COLLINSVILLE, IL 62234-4658
(618) 344-8800
(618) 344-8020
Mailing address
7212 BALSON AVE, SAINT LOUIS, MO 63130-3001
(314) 726-5600
(314) 754-9317
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1010588
IL
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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