Organization
CBC FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAKENZIE WALTON (DIRECTOR)
(314) 449-0544
Entity
Organization
Contact information
Practice address
3419 REX AVE, SAINT LOUIS, MO 63114-2930
(314) 449-0544
Mailing address
3419 REX AVE, SAINT LOUIS, MO 63114-2930
(314) 449-0544
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/04/2017
Last updated
02/04/2017
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