Organization
MRS OCTAVIA HOME HEALTH CARE LLC
Active
Parent organization
-
Organization subpart
Yes
Provider details
NPI number
Legal business name
-
Authorized official
DEBRA EDWARDS (OWNER)
(314) 226-4500
Entity
Organization
Contact information
Practice address
1516 GOODFELLOW BLVD UNIT-A, 1516 GOODFELLOW BLVD APT-A, SAINT LOUIS, MO 63112
(314) 226-4500
Mailing address
1516 GOODFELLOW BLVD UNIT-A, 1516 GOODFELLOW BLVD UNIT-A, SAINT LOUIS, MO 63112
(314) 652-4209
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
11/15/2023
Last updated
11/23/2023
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