Organization
HOUSE OF MARIAM HOLISTIC HOME HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIDA H AMEGASHIE (CEO)
(708) 314-8159
Entity
Organization
Contact information
Practice address
1543 S SONORA DR, COLUMBIA, MO 65201-9471
(708) 314-8159
Mailing address
1543 S SONORA DR, COLUMBIA, MO 65201-9471
(708) 314-8159
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
405300000X
Prevention Professional
Primary
—
—
Other
Enumeration date
08/10/2024
Last updated
08/10/2024
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