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Organization

BREEZE HOSPICE OF MISSOURI, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KULSOOM FATIMA JUNAID M.D. (ADMINISTRATOR)
(314) 922-2662
Entity
Organization

Contact information

Practice address
3535 S JEFFERSON AVE, SUITE 118, SAINT LOUIS, MO 63118-3930
(314) 833-3180
(314) 833-3179
Mailing address
3535 S JEFFERSON AVE, SUITE 118, SAINT LOUIS, MO 63118-3930
(314) 833-3180
(314) 833-3179

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
244-HO
STATE LICENCE
MO
Enumeration date
09/03/2015
Last updated
02/07/2020
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