Organization
EXPRESS HOME CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SHELTON (ADMINISTRATOR)
(314) 727-0453
Entity
Organization
Contact information
Practice address
3641 OAKDALE AVE, SAINT LOUIS, MO 63121-5437
(314) 727-0453
(314) 727-6067
Mailing address
3641 OAKDALE AVE, SAINT LOUIS, MO 63121-5437
(314) 727-0453
(314) 727-6067
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266366301
—
MO
Enumeration date
07/25/2024
Last updated
07/25/2024
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