Organization
KANDKSENIORSERVICESLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERNITA MOLINA (OWNER/DIRECTOR)
(314) 791-9390
Entity
Organization
Contact information
Practice address
4110 BOTANICAL AVE, SAINT LOUIS, MO 63110-3908
(314) 791-9390
(314) 300-8366
Mailing address
4110 BOTANICAL AVE, SAINT LOUIS, MO 63110-3908
(314) 791-9390
(314) 300-8366
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
LC9806604
MO
Other
Enumeration date
06/23/2016
Last updated
06/23/2016
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