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Individual

AMEANNA VUSU HAMILTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6500 OLD MISSOURI AVE, CENTREVILLE, IL 62207-2356
(618) 857-2170
(618) 857-2170
Mailing address
6500 OLD MISSOURI AVE, CENTREVILLE, IL 62207-2356
(618) 857-2170
(618) 857-2170

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
3001843
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3001843
HOMECARE SERVICE
IL
Enumeration date
12/19/2020
Last updated
12/19/2020
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