Organization
ACTIVE ANGELS IN HOME HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON LORETTA PETERS STATE CERTIFIED (DIRECTOR(OWNER))
(314) 524-4200
Entity
Organization
Contact information
Practice address
9191 W FLORISSANT AVE, SUITE 215, SAINT LOUIS, MO 63136-1424
(314) 524-4200
(314) 524-4203
Mailing address
9191 W FLORISSANT AVE, SUITE 215, SAINT LOUIS, MO 63136-1424
(314) 524-4200
(314) 524-4203
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
LCO762551
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008897
SSBG GR
MO
Enumeration date
03/20/2007
Last updated
08/02/2013
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