Organization
STAT J IN HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TWANIECE JOHNSON (DIRECTOR)
(314) 695-5113
Entity
Organization
Contact information
Practice address
12942 COVINGTON GARDENS DR, SAINT LOUIS, MO 63138-1528
(314) 695-5113
(314) 932-5009
Mailing address
12942 COVINGTON GARDENS DR, SAINT LOUIS, MO 63138-1528
(314) 695-5113
(314) 932-5009
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
LC1302938
MO
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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