Organization
A LIVING WATER IN HOME HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELORES BINGHAM (DIRECTOR)
(314) 874-9616
Entity
Organization
Contact information
Practice address
3029 SAINT VINCENT AVE, SAINT LOUIS, MO 63104-1421
(314) 874-9616
(314) 000-0000
Mailing address
3029 SAINT VINCENT, SAINT LOUIS, MO 63104
(314) 874-9616
(314) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251E00000X
—
MO
Enumeration date
03/09/2017
Last updated
03/09/2017
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