Organization
LIVING MY BEST LIFE CDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KSI PENNY (EXECUTIVE DIRECTOR)
(314) 695-4244
Entity
Organization
Contact information
Practice address
3004 S JEFFERSON AVE, SAINT LOUIS, MO 63118-1513
(314) 695-4244
Mailing address
3004 S JEFFERSON AVE, SAINT LOUIS, MO 63118-1513
(314) 695-4244
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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