Organization
ANGELS BY THE WINGS HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAVONDA COOPER (OWNER)
(314) 553-9306
Entity
Organization
Contact information
Practice address
5227 GRAVOIS AVE 1ST FLOOR, ST LOUIS, MO 63116
(314) 553-9306
(314) 553-9307
Mailing address
5227 GRAVOIS AVE 1ST FLOOR, ST LOUIS, MO 63116
(314) 553-9306
(314) 553-9307
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
372500000X
Chore Provider
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2222004
—
MO
Enumeration date
03/19/2018
Last updated
07/28/2023
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