Organization
4TH GENERATION CDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY D MOORE (EXECUTIVE DIRECTOR)
(314) 379-4017
Entity
Organization
Contact information
Practice address
8700 GOODFELLOW BLVD, SAINT LOUIS, MO 63147-1446
(314) 376-4017
Mailing address
8700 GOODFELLOW BLVD, SAINT LOUIS, MO 63147-1446
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/19/2026
Last updated
02/19/2026
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