Organization
BE OF SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALFREDA BRONNER (OWNER)
(314) 944-0461
Entity
Organization
Contact information
Practice address
11150 MAMMOTH DR, SAINT LOUIS, MO 63136-5845
(314) 944-0461
(314) 944-0461
Mailing address
11150 MAMMOTH DR, SAINT LOUIS, MO 63136-0913
(314) 944-0461
(314) 944-0461
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
372500000X
Chore Provider
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730700360
—
MO
01
—
37250000X
CHORE PROVIDER
MO
Enumeration date
05/05/2020
Last updated
02/17/2021
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