Organization
HOMERS HAVEN HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IESHA MITCHELL (EXECUTIVE DIRECTOR)
(314) 201-8819
Entity
Organization
Contact information
Practice address
5636 PAMPLIN PL, ST LOUIS, MO 63136
(314) 201-8819
Mailing address
5636 PAMPLIN PL, ST LOUIS, MO 63136
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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