Organization
COUCHSIDE COMMUNITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOREAINE BROWN (OWNER)
(314) 302-3773
Entity
Organization
Contact information
Practice address
224 GLADYS AVE, SAINT LOUIS, MO 63135-1031
(314) 302-3773
Mailing address
224 GLADYS AVE, SAINT LOUIS, MO 63135-1031
(314) 302-3773
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
MO
Other
Enumeration date
06/08/2018
Last updated
06/08/2018
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