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Organization

DELMAR GARDENS PRIVATE SERVICES, LLC

Active
Other names
Delmar Gardens Private Services
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRYAN MICHAEL BACKOWSKI (DIRECTOR)
(636) 733-7330
Entity
Organization

Contact information

Practice address
14805 N OUTER 40 RD STE 320A, CHESTERFIELD, MO 63017-6021
(636) 733-7100
(636) 733-7101
Mailing address
14805 N OUTER 40 RD STE 320A, CHESTERFIELD, MO 63017-6021
(636) 733-7100
(636) 733-7101

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251K00000X
Public Health or Welfare Agency
Primary
253Z00000X
In Home Supportive Care Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
260563713
MO
05
280563701
MO
Enumeration date
09/16/2005
Last updated
01/09/2025
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