Organization
LIFETIME SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CYNTHIA COMPTON (EXECUTIVE DIRECTOR)
(314) 599-7020
Entity
Organization
Contact information
Practice address
6748 FYLER AVE, SAINT LOUIS, MO 63139-2239
(314) 644-1813
Mailing address
6748 FYLER AVE, SAINT LOUIS, MO 63139-2239
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
03/05/2009
Last updated
03/05/2009
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