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Organization

HEAVEN SCENT CONSUMER DIRECTED SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAKENDRA SHARON HUNT NURSE PRACTITONER (EXECUTIVE DIRECTOR)
(314) 438-0955
Entity
Organization

Contact information

Practice address
15610 DEBRIDGE WAY, FLORISSANT, MO 63034-3472
(314) 556-1413
Mailing address
3379 N HIGHWAY 67, FLORISSANT, MO 63033-1604
(314) 438-0955

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018466
MO
Enumeration date
08/05/2016
Last updated
07/21/2022
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