Organization
LACLEDE GROVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OTHA THOMAS LPN (DIRECTOR OF HEALTH SERVICES)
(314) 446-2462
Entity
Organization
Contact information
Practice address
727 S LACLEDE STATION RD, SAINT LOUIS, MO 63119-4911
(314) 446-2462
(314) 446-2397
Mailing address
727 S LACLEDE STATION RD, SAINT LOUIS, MO 63119-4911
(314) 446-2462
(314) 446-2397
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
—
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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