Organization
TKB HOME CARE CDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKESHA WHITT (OFFICE MANAGER)
(314) 839-1210
Entity
Organization
Contact information
Practice address
580 N HIGHWAY 67 ST, SUITE 6A, FLORISSANT, MO 63031-5130
(314) 839-1210
(314) 831-3577
Mailing address
580 N HIGHWAY 67 ST, SUITE 6A, FLORISSANT, MO 63031-5130
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016619
—
MO
Enumeration date
07/28/2016
Last updated
09/07/2016
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