Organization
SENIOR SOURCE CDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAMIKKA CARLSON (EXECUTIVE DIRECTOR)
(314) 709-3976
Entity
Organization
Contact information
Practice address
7733 FORSYTH BLVD STE 1106, CLAYTON, MO 63105-1817
(314) 296-6005
(855) 940-0173
Mailing address
7733 FORSYTH BLVD STE 1106, CLAYTON, MO 63105-1817
(314) 296-6005
(855) 940-0173
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
05/23/2025
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