Organization
CENTER STAGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALFREDA MARIE SMITH RN, BSN (OWNER/ADMINISTRATOR)
(314) 533-6600
Entity
Organization
Contact information
Practice address
3923 WASHINGTON BLVD, SAINT LOUIS, MO 63108-3507
(314) 533-6600
(314) 533-6601
Mailing address
3923 WASHINGTON BLVD, SAINT LOUIS, MO 63108-3507
(314) 533-6600
(314) 533-6601
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
LC9274711
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M265894303
—
MO
05
—
M285894309
—
MO
Enumeration date
05/17/2010
Last updated
05/17/2010
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