Organization
GRANDMA'S ANGELS CONSUMER DIRECTED SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MOZZIE L BETTS (EXECUTIVE DIRECTOR)
(314) 435-0009
Entity
Organization
Contact information
Practice address
13132 NORTHVIEW HEIGHTS CT, BLACK JACK, MO 63033-4564
(314) 435-0009
Mailing address
13132 NORTHVIEW HEIGHTS CT, BLACK JACK, MO 63033-4564
(314) 435-0009
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
253Z00000X
MO
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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