Individual
TAKESHA SHARICE GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1614 PAGE INDUSTRIAL BLVD, APT A, OVERLAND, MO 63132
(314) 896-3713
Mailing address
561 KINGSLAND AVE UNIT 300115, SAINT LOUIS, MO 63130-5005
(314) 896-3713
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
X001395190
MO
253Z00000X
In Home Supportive Care Agency
Primary
X001395190
MO
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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