Organization
DIVERSE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAVINCENT HOOKER (OWNER)
(314) 667-5951
Entity
Organization
Contact information
Practice address
4200 UNION BLVD, SUITE 110, SAINT LOUIS, MO 63115-1227
(314) 667-5951
Mailing address
3620 N SPRING AVE, SAINT LOUIS, MO 63107-2220
(314) 667-5951
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
02/23/2010
Last updated
11/12/2014
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