Organization
TRUSTED ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERRICK D MUNNS (PARTNER)
(314) 692-9130
Entity
Organization
Contact information
Practice address
12045 VIVACITE DR, SAINT LOUIS, MO 63146-5219
(314) 692-9130
(314) 692-9143
Mailing address
12045 VIVACITE DR, SAINT LOUIS, MO 63146-5219
(314) 692-9130
(314) 692-9143
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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