Organization
FRIENDSHIP VILLAGE AT HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES TERRY WALSH (CHIEF EXECUTIVE OFFICER)
(314) 270-7150
Entity
Organization
Contact information
Practice address
12563 VILLAGE CIRCLE DR, SAINT LOUIS, MO 63127-1758
(314) 270-7333
Mailing address
12563 VILLAGE CIRCLE DR, SAINT LOUIS, MO 63127-1758
(314) 270-7333
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/07/2017
Last updated
01/05/2018
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