Organization
MERCY & MIRACLE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA JOHNSON (OWNER)
(314) 401-8028
Entity
Organization
Contact information
Practice address
2055 WALTON RD, OVERLAND, MO 63114-5805
(314) 401-8028
Mailing address
514 EARTH CITY PLZ STE 312, EARTH CITY, MO 63045-1303
(314) 222-8130
(314) 492-0196
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/16/2021
Last updated
03/12/2025
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