Organization
AGILE IN-HOME CARE, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BROOKE B LEWIS (DIRECTOR)
(816) 805-3974
Entity
Organization
Contact information
Practice address
320 BROOKES DRIVE, SUITE 207, HAZELWOOD, MO 63042
(314) 443-7565
(314) 298-3886
Mailing address
2804 ROSE ACRES LANE, MARYLAND HEIGHTS, MO 63043-1180
(314) 443-7565
(314) 298-3886
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
LC1153679
MO
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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