Organization
ISAIAH'S ANGELS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN WARREN (DIRECTOR)
(314) 322-3994
Entity
Organization
Contact information
Practice address
5261 DELMAR BLVD, SUITE 210B, SAINT LOUIS, MO 63108-1063
(314) 322-3994
Mailing address
8739 AGATE CT, SAINT LOUIS, MO 63136-3700
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
LC9814999
MO
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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