Organization
MI AMOR CDS - 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYANT DAVIS (EXECUTIVEBDIRECTOR)
(636) 484-1530
Entity
Organization
Contact information
Practice address
2200 W PORT PLAZA DR STE 300, SAINT LOUIS, MO 63146-3211
(636) 484-1530
Mailing address
2200 W PORT PLAZA DR STE 300, SAINT LOUIS, MO 63146-3211
(636) 484-1530
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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