Organization
MRS OCTAVIA INHOME HEALTH CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA EDWARDS (OWNER)
(314) 260-9106
Entity
Organization
Contact information
Practice address
1516 GOODFELLOW BLVD APT A1516, SAINT LOUIS, MO 63112-3828
(314) 652-4209
(314) 226-4500
Mailing address
1516 GOODFELLOW BLVD APT A, SAINT LOUIS, MO 63112-3828
(314) 260-9106
(557) 467-2616
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
06/20/2023
Last updated
01/20/2025
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